Statistical process control and direct care staff performance

Dey, Michael L.; Sluyter, Gary V.; Keating, Joseph E.

doi:10.1007/bf02521327

Cited by 8 publications

(5 citation statements)

References 4 publications

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“…SPC provides a systematic means of monitoring the amount of variability in a continuous production process. It has been used in mental health settings to measure consistency of service delivery at outpatient clinics (Green, 1999) and variations in treatment staff performance over time (Dey, Sluyter, & Keating, 1994). In SPC, samples are taken from a given process under investigation (e.g., FT fidelity in RFT) and plotted on a control chart to check for patterns that suggest systematic variation within the target sample when compared to pre-established control limits (e.g., fidelity benchmark values derived from MDFT studies).…”

Section: Methodsmentioning

confidence: 99%

Assessing fidelity to evidence-based practices in usual care: The example of family therapy for adolescent behavior problems

Hogue

Dauber

2013

Evaluation and Program Planning

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This study describes a multimethod evaluation of treatment fidelity to the family therapy (FT) approach demonstrated by front-line therapists in a community behavioral health clinic that utilized FT as its routine standard of care. Study cases (N = 50) were adolescents with conduct and/or substance use problems randomly assigned to routine family therapy (RFT) or to a treatment-as-usual clinic not aligned with the FT approach (TAU). Observational analyses showed that RFT therapists consistently achieved a level of adherence to core FT techniques comparable to the adherence benchmark established during an efficacy trial of a research-based FT. Analyses of therapist-report measures found that compared to TAU, RFT demonstrated strong adherence to FT and differentiation from three other evidence-based practices: cognitive-behavioral therapy, motivational interviewing, and drug counseling. Implications for rigorous fidelity assessments of evidence-based practices in usual care settings are discussed.

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Section: Methodsmentioning

confidence: 99%

Assessing fidelity to evidence-based practices in usual care: The example of family therapy for adolescent behavior problems

Hogue

Dauber

2013

Evaluation and Program Planning

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“…To facilitate this communication, monthly updates to the control charts used to monitor ongoing CQI projects are posted on a large bulletin board [and also distributed at meetings, and sent out by e-mail]'' (Ornstein et al, 34 p 353) 20 Knowing the clinical context helped in the interpretation of control charts 25 Discussing the issue that blood glucose tests are taken more frequently from patients whose blood glucose level is deranged, investigators argue that they ''interpret the charts in context, aware that points are weighted toward derangements'' (Oniki et al, 25 …”

mentioning

confidence: 99%

Application of statistical process control in healthcare improvement: systematic review

Thor

Lundberg

Ask

et al. 2007

Quality and Safety in Health Care

338

242

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Objective: To systematically review the literature regarding how statistical process control-with control charts as a core tool-has been applied to healthcare quality improvement, and to examine the benefits, limitations, barriers and facilitating factors related to such application. Methods: A standardised data abstraction form was used for extracting data relevant to the review questions, and the data were analysed thematically. Results: Statistical process control was applied in a wide range of settings and specialties, at diverse levels of organisation and directly by patients, using 97 different variables. The review revealed 12 categories of benefits, 6 categories of limitations, 10 categories of barriers, and 23 factors that facilitate its application and all are fully referenced in this report. Statistical process control helped different actors manage change and improve healthcare processes. It also enabled patients with, for example asthma or diabetes mellitus, to manage their own health, and thus has therapeutic qualities. Its power hinges on correct and smart application, which is not necessarily a trivial task. This review catalogues 11 approaches to such smart application, including risk adjustment and data stratification. Conclusion: Statistical process control is a versatile tool which can help diverse stakeholders to manage change in healthcare and improve patients' health.

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“…To wit: Is it justified to single out therapist 30 due to his/her lower performance on two outcomes averaged across two clients? SPC is most powerful when employed in an assembly-line context as part of a continuous production process (e.g., Dey, Sluyter, & Keating, 1994), for example tracking clinical staff within a provider system over several years, in which deviations can be detected for a given time window as well as a given therapist (Green, 1999). And because it is designed to distinguish between normal variation and systematic uncontrolled variation, SPC may be ideal for supporting line clinicians who are responsible for consistent delivery of EBTs yet also expected to show natural variation in implementation across sessions and caseloads (Delgadillo et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Benchmarking Family Therapy for Adolescent Behavior Problems in Usual Care: Fidelity, Outcomes, and Therapist Performance Differences

Hogue

Dauber

Henderson

2016

Adm Policy Ment Health

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This study evaluated whether community therapists delivering family therapy for adolescent behavior problems in usual care achieved performance benchmarks established in controlled trials for treatment fidelity and outcomes, with particular focus on individual differences in therapist performance. The study contained N = 38 adolescents (50% male; mean age 15 years) whose self-reported race/ethnicity was Hispanic (74%), African American (11%), multiracial (11%), and other (4%). Clients were treated by 13 therapists in one community mental health clinic that delivered family therapy as the routine standard of care. Therapists provided self-report data on adherence to core family therapy techniques; these scores were inflation-adjusted based on concordance with observer reports. Results showed that community therapists surpassed the fidelity benchmark for core family therapy techniques established by research therapists during a controlled trial. Regarding change in client functioning at six-month follow-up, community therapists were equivalent to the benchmark for internalizing symptoms and superior for externalizing symptoms and delinquent acts. Community therapists also demonstrated a high degree of performance uniformity: Each one approximated the fidelity benchmark, and only two produced relatively weak outcomes on any of the client change indicators. Caveats for interpreting therapist performance data, given the small sample size, are described. Recommendations are made for developing therapist-report fidelity measures and utilizing statistical process control methods to diagnose therapist differences and enhance quality assurance procedures.

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Statistical process control and direct care staff performance

Cited by 8 publications

References 4 publications

Assessing fidelity to evidence-based practices in usual care: The example of family therapy for adolescent behavior problems

Assessing fidelity to evidence-based practices in usual care: The example of family therapy for adolescent behavior problems

Application of statistical process control in healthcare improvement: systematic review

Benchmarking Family Therapy for Adolescent Behavior Problems in Usual Care: Fidelity, Outcomes, and Therapist Performance Differences

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