Provider perceived barriers and facilitators to integrating routine outcome monitoring into practice in an urban community psychiatry clinic: A mixed‐methods quality improvement project

Abstract

Background and Aims Although mental health clinics are under increasing pressure to demonstrate value and routine outcome monitoring (ROM) has become a mandated component of care, providers have been slow to adopt ROM into practice, with some estimating that less than 20% of mental health clinicians use it consistently in the United States. This article explores perceived barriers and facilitators to integrating ROM into practice among clinicians and administrators in a large urban US community psychiatry clinic. Method One hundred and thirty‐eight clinical and administrative staff were administered an anonymous web‐based survey to elicit attitudes towards ROM. Responses were summarized descriptively and qualitatively synthesized into a conceptual model using inductive thematic analysis. Results Common barriers to integration included insufficient time to collect and/or use measures, not knowing what measures to use, measures being difficult to access, and insufficient training. Facilitators included increased access/ease of use, training and support, measure relevance/validity, and accountability. Conclusions In order for psychiatry clinics to successfully implement ROM into practice, they must diagnose organization‐side barriers and translate this knowledge into actionable quality improvement initiatives ranging from the infrastructural to the cultural.

The Efficacy of Measurement-Based Care for Depressive Disorders

“…16,17 MBC may also help to identify treatment nonresponders, detect residual symptoms, and increase treatment adherence by encouraging patient participation. [18][19][20][21] Although there are recognized barriers and facilitators to implementation and scalability of MBC, 22,23 its feasibility for depression treatment in clinical settings and propensity to improve patient outcomes were demonstrated in several large trials and projects. 11,24,25 Despite these benefits, MBC continues to be underutilized in clinical practice.…”

Evaluation of an Online System for Routine Outcome Monitoring: Cross-sectional Survey Study

“…Although 56 out of 98 (57%) service providers responded that the online system was less time-consuming than were previous paper-based methods, only 31 out of 98 (31%) responded that the system did not increase their workload. One of the main barriers identified in previous literature to the utilization of ROM has been the significant time burden involved, and it has been suggested that software systems may alleviate some of the burden [ 5 , 12 , 35 , 36 ]. The results of the current study, with 58% (56/98) of service providers responding that the online system was less time-consuming, show promise for improvement in ROM utilization if an online system is adopted.…”

Monitorización de Resultados en Psicoterapia: Estado Actual y Perspectivas Futuras en Iberoamérica

“…Estos se agrupan en: obstáculos relacionados con los sistemas usados para la MRR, obstáculos relacionados con las personas y obstáculos organizativos. Prever estos desafíos en la implementación constituye la principal herramienta para asegurar el uso fructífero de la MRR (Barkham et al, 2023;Lewis et al, 2019;Van Wert et al, 2021).…”