Implementing Measurement-Based Care in an Outpatient Mental Health Clinic

Abstract

Problem: Measurement-based care (MBC) in psychotherapy is an evidence-based intervention that involves routinely monitoring client-reported outcome measures and progress over time with incorporation of feedback into sessions. At a large outpatient mental health clinic (OMHC), therapists have no centralized method of measuring symptom changes that provides immediate analysis to show detailed change or client progress; therefore, feedback cannot effectively be incorporated into sessions. Purpose: This quality improvement project aims to implement and evaluate the effectiveness of a specialized MBC software to improve client outcomes at this OMHC. Methods: Following the software launch in April 2021, initial facilitators and barriers to implementation were assessed. In September 2021, educational interventions on MBC and peer-to-peer supportive consultations were integrated into all staff meetings and collaborative education sessions, facilitated by change champions. Changes in software utilization and aggregated outcomes were tracked by collecting data weekly from August through December 2021. Results: 100% of new intakes were enrolled into the software on 13 of the 20 weeks of data collection with a statistically significant increase in enrollment over the course of implementation. The assessment completion rate dropped consistently from 52% to 38% during this time. Improvements in clinical outcomes (depression, anxiety, pediatric symptoms) were seen among all clients cumulatively since April 2021 and among an inclusive sample of all nineteen clients who began treatment in August 2021. Conclusions: MBC delivered through a specialized software has been integrated as a primary tool in psychotherapy at this OMHC. This evidence-based intervention has provided a way to show objective clinical outcome changes over time in treatment and may help improve outcomes.