Do you actually know which of your particular treatment approaches are working when you use the more traditional pre-post measures of outcomes? I think not! As a psychologist and performance improvement
consultant for 40 years, I am excited that real-time, “as-you-deliver-service”
measures can actually show you and your patient (not just you) which interventions are producing positive outcomes for them and which are not.
Feedback-Informed Treatment (FIT), developed by Scott Miller, Ph.D., and described in
an article in PsychCentral titled, “Feedback-Informed-Treatment (FIT): Empowering Clients to Use Their Voices,” allows the
therapist to use per-session outcome and therapeutic alliance measures to improve the “fit”
between therapist and client. According
to research cited by Miller, 97% of the variability between therapist and
client can be attributed to the quality of the therapeutic alliance. In fact, he notes that therapists who show
improvement in alliance in response to real-time client feedback have 50%
higher outcomes at the end of treatment.
He describes two 4-item question sets, the ORS
(for measuring outcome) and the SRS
(for measuring alliance) that are collected at the outset and end of a session, how to explain them, administer them and how
to use the feedback during the therapy session.
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| From Public Health Consulting Group – Providing Consultation in Clinical Trials and Health Outcomes Research |
The move toward measuring Patient Reported Outcomes (PRO) is
somewhat similar to Miller’s FIT. It is described by David
Hopkins, PhD and Jennifer
Eames Huff, MPH in their Action
Brief: Patient Reported Outcomes for the Consumer-Purchaser
Alliance. The purpose is to
determine if the “care patients received made a difference in their lives.” PRO measurement looks at outcomes in areas of
physical and mental functioning as well as changes in symptoms, collecting
measures at various time intervals, e.g., every 3 months.
Based on my many years of consulting with organizations
regarding performance improvement, including looking at outcomes, this
psychologist thinks it is very important to start finding out what our patients
say about the effect of our treatments on them.
Here are 3 tips to get started:
Start asking
patients – Miller’s ORS and SRS measures look to be the simplest and most
real-time PRO.
Turn
staff on – Show them the research on retention and outcomes Miller reports
and follow his guidelines in teaching them how to engage their patients in this
PRO activity
Graph
patient scores – Set up a simple Excel spreadsheet with graph so staff can
enter scores over time and run reports by patient to see performance over time.
Start today to find what’s
working for your patients.
My name is Genie
Skypek, Ph.D. I am an entrepreneurial psychologist
– meaning I’ve done multiple different things – outcome measurement for
juvenile delinquency programs in Orlando, consulting in performance improvement
and clinical documentation - nationally, health psychology, pain management,
feminist therapy, education in Women’s Studies at the University of South
Florida in Tampa, eLearning author for myLearningPointe. In addition, I have surveyed for The Joint Commission
for 40 years.
I can be reached at Twitter @genieskypekphd, LinkedIn and at Google+
I can be reached at Twitter @genieskypekphd, LinkedIn and at Google+
I am currently taking
a What
is Social course through Coursera, taught by
Randy Hlavac through Northwestern
University.
