MEASURING OUTCOMES IN PSYCHIATRY - AN INPATIENT MODEL

Background: This article describes a system for measuring outcomes rec ently implemented in the department of psychiatry of Baptist Memorial Hospital, a 78-bed inpatient and day treatment unit that represents on e service line of a large, urban teaching hospital in Memphis. In June 1993 Baptist Hospital began a 15-month pilot test of PsychSentinel, a measurement tool developed by researchers in the Department of Commun ity Medicine at the University of Connecticut. The hospital identified the following four primary goals for this pilot project: provide data for internal hospital program evaluation, provide data for external m arketing in a managed care environment, satisfy requirements of the Jo int Commission on Accreditation of Health Care Organizations, and gene rate studies that add to the literature in psychiatry and psychology. Description of measure: PsychSentinel is based on the standardized dia gnostic criteria in the Diagnostic and Statistical Manual of Mental Di sorders, 4th edition (DSM-IV). The outcome measure assesses the change in the number of symptoms of psychopathology that occurs between admi ssion and discharge from the hospital. Included in the nonproprietary system are risk adjustment factors, as well as access to a national re ference database for comparative analysis purposes. Data collection ca n be done by trained ancillary staff members, with as much or as littl e direct physician involvement as desired. The system has proven to be both time effective and cost effective, and it provides important out come information both at the program level and at the clinician level. Results: After the pilot test, the staff at Baptist Memorial Hospital determined that the system met all initial objectives identified and recently adopted the system as an ongoing measure of quality patient c are in the department of psychiatry.