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Improving Mental Healthcare

A Guide to Measurement-Based Quality Improvement

Richard C. Hermann, M.D., M.S.

  • ISBN 978-1-58562-088-3
  • Item #62088

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The first book to focus on measuring the basic processes of mental healthcare, such as access, detection, treatment appropriateness, safety and continuity of care, Improving Mental Healthcare: A Guide to Measurement-Based Quality Improvement integrates practical information about quality measures—such as their clinical logic, validity and basis in scientific evidence—into a highly readable guide on how to implement measures and use the results to improve quality of care.

Improving Mental Healthcare examines the clinical, policy, and scientific underpinnings of process measurement, a widely used method of assessing quality of mental healthcare. It describes the use of measurement to improve quality, promote accountability, encourage evidence-based practice, and shape incentives to favor delivery of high-quality care.

Divided into two sections totaling 14 chapters, the first section describes factors that led to a nationwide emphasis on improving quality of care, major approaches to quality assessment, considerations in selecting measures, as well as how to analyze and interpret measure results. The second section summarizes information on more than 300 quality measures, including their clinical rationale, specifications, sources of data, supporting evidence, readiness for use, and—where available—data on reliability, validity, results, case-mix adjustment, standards, and benchmarks.

Improving Mental Healthcare helps clinicians, managers, administrators, payers, purchasers, accreditors, consumer groups, and other stakeholders meet national mandates to assess and improve quality of care by providing the following tools and guidance:

  • Results from the National Inventory of Mental Health Quality Measures, a federally funded study summarizing clinical, technical, and scientific properties of more than 300 process measures
  • A user-friendly format that helps potential measure users find quality measures that reflect their priorities and meet their needs
  • Guidance for healthcare organizations and clinicians on how to integrate measurement into a comprehensive approach to quality management
  • An understanding of the relationship between process measurement and other approaches to quality assessment, in particular outcomes assessment-the focus of a companion guide, Outcome Measurement in Psychiatry: A Critical Review (APPI 2002)

      Improving Mental Healthcare, which includes extensive references as well as useful figures and tables illustrating key concepts, is essential reading for practicing clinicians, healthcare managers, medical students and psychiatric residents—who must now meet ACGME requirements to learn about quality assessment and improvement—as well as members of oversight organizations and consumer advocacy groups. It will prove invaluable for healthcare organizations seeking to improve quality of care, clinical training programs, and courses on quality assessment, healthcare management, and mental health policy.


  • Acknowledgments
  • Foreword
  • Introduction
  • Part I: Role of Process Measures in Quality Assessment and Improvement
  • Chapter 1. Quality Assessment and Improvement in a Changing Healthcare System
  • Chapter 2. Measuring Clinical and Administrative Processes of Care
  • Chapter 3. Selecting Process Measures
  • Chapter 4. Comparing and Interpreting Results From Process Measurement
  • Chapter 5. Role of Measurement in Quality Improvement
  • Part II: National Inventory of Mental Health Quality Measures
  • Chapter 6. Guide to Inventory Data
  • Chapter 7. Prevention Measures
  • Chapter 8. Access Measures
  • Chapter 9. Assessment Measures
  • Chapter 10. Treatment Measures
  • Chapter 11. Coordination Measures
  • Chapter 12. Continuity Measures
  • Chapter 13. Patient Safety Measures
  • Appendix
  • Subject Index
  • Measures Subject Index
  • Index of Measures by Domain of Quality
  • Index of Measures by Diagnosis
  • Index of Measures by Treatment Modality
  • Index of Measures by Population Characteristics
  • Index of Measures by Data Source

About the Authors

Richard C. Hermann, M.D., M.S., is Associate Professor of Medicine and Psychiatry at Tufts University School of Medicine, Director of the Center for Quality Assessment and Improvement in Mental Health (CQAIMH), Institute for Clinical Research and Health Policy Studies at Tufts-New England Medical Center, and Adjunct Associate Professor of Health Policy and Management at Harvard School of Public Health.

This outstanding book provides a comprehensive framework for the use of quality indicators within the context of quality improvement initiatives in real practice. Dr. Hermann provides for the field a comprehensive set of measures in use in practice, as well as research studies, during an active period of development of the quality of care and quality improvement field. The book integrates a thorough understanding of the practical uses of quality measurement with an understanding of the market context for their use, and standards for acceptable measures that can span practice and research. The book is the most comprehensive book available on quality measurement, from a practical perspective, in the field.—Ken Wells, M.D., M.P.H., Professor, David Geffen School of Medicine and UCLA School of Public Health; Senior Scientist of the Semel Institute and RAND

At last mental healthcare gets serious attention in the quest for higher quality of care! Improving Mental Healthcare: A Guide to Measurement-Based Quality Improvement by Richard Hermann is packed with valuable information. Readers whose primary focus is not on mental health will learn much in general about quality measurement and improvement in healthcare. The opening chapters sweep from details of methodology to broad principles and strategies for quality improvement. The later chapters capture precise details of an inventory of quality measures for mental healthcare. Together with writing that flows so smoothly throughout, I cannot think of a better introduction to quality in healthcare. A feast indeed!—R. Heather Palmer, M.B.B.Ch., S.M., Professor of Health Policy and Management, Director of the Center for Quality of Care Research and Education, Harvard School of Public Health

Author Richard Hermann has put together an amazingly complete compilation of well referenced methods and instruments for measuring quality of care in psychiatry, mental health, and substance abuse. This work creates neat order out of what had been a chaotic jumble. This book provides solid ammunition for these related fields to defend their worth against both a needy but unconvinced and disbelieving public, and the bean counters simultaneously. A magnificent and exhaustive, definitive and detailed organized tabulation of ways to measure the quality of care in mental health, whether or not it works, is improving or not, and how you can tell.—George D. Lundberg, M.D., Editor in Chief, Medscape General Medicine

This guidebook fills a gap in the professional literature for those of us who design behavioral health delivery systems and measure progress. While the scope is encyclopedic in conveying the history and processes of measurement available, the content is well organized so that the reader can go easily and directly to the area of interest. I know that we will be regularly thumbing through Dr. Hermann's book for guidance and information as we continue to chart our future course.—Michael P. Quirk, Ph.D., M.S., Director Behavioral Health Service, Group Health Cooperative of Puget Sound, Seattle, Washington

Improving the quality of care for persons with mental disorders challenges all of us, whether we are involved in the delivery of care or are one of the millions who receive or have loved ones who receive mental health care. Once the commitment has been made to focus on quality, the immediate challenge is, how? For those who have made this commitment, Improving Mental Healthcare offers a wealth of tools on how to assess quality, the first step in quality improvement.—Anthony F. Lehman, M.D., M.S.P.H., Professor and Chair, Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland

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