The purpose of the state quality management system for alcohol and other drug treatment services is to collect and use information to improve efficiencies or show the effectiveness of services. OhioMHAS is using two treatment measures at four levels to implement the system. The two measures are retention and disposition at discharge, and the four levels are provider, board, region and state. National data will also be provided if applicable and available.
The 18 different dispositions at discharge have been grouped into five categories for quality management:
The Referral category also consists of two dispositions:
There are five Unsuccessful dispositions:
There are three, one-page reports for the two measures: two for the retention indicators and one for the disposition at discharge information. There are also summary reports for each. The information in the reports is based on unduplicated client information when there is both an admission record and a discharge record that is linked to a Unique Provider Identification (UPID) number. Client admission dates are used for the reporting quarters. The UPID represents the OhioMHAS certified program site number, which is the physical address of the site.
The retention reports provide results for five quarters beginning with the first quarter of state fiscal year (SFY) 2011, i.e. July 1, 2010 to September 30, 2010. For subsequent reports, the oldest quarter is dropped and a new quarter added. Results are not final until a SFY reporting period is completed, which usually occurs by November after the end of the fiscal year. Results for the current SFY are cumulative totals. The deposition at discharge reports are based on SFY; therefore, results during a current fiscal year are also cumulative totals.
The reports are simple and easy to understand and provide information about what might be happening at a provider, board, region or state level. The quality management measures provide information that may lead to asking questions, which can identify possible areas to target for improvement such as capacity issues, quality of care and organizational culture. Quality management creates a culture of quality where customers are the focus, data are used to drive decisions and team work solves problems, thereby increasing a sense of ownership of processes.
A variety of factors can affect, influence or impact the information in the reports; therefore, caution must be used in interpreting or making judgment about the results. It is important to know what the data represent before drawing any conclusions or using the information for decision making. The following are some of the factors that can limit the utility of the reports:
At the state level, OhioMHAS is looking at the extreme results or outliers to help determine what appears to work well and what appears to be not working well. The Department works with providers who volunteer to participate in the project. Validity and reliability will also be considered, i.e. the degree to which the measures are actually being measured (validity) and if the information is being collected in the same way each time (reliability). Working with the volunteer providers, OhioMHAS will use the NIATx model for process improvement to implement the Plan, Do, Study and Act (PDSA) cycle as a means to make changes at agencies to get the desired results. For more information, visit www.niatx.net.
Definitions used in the state quality management system
Webinar Series - April 25 to May 3, 2012, PowerPoint
Terry Porter Patel, OhioMHAS Office of Quality, Planning and Research, 614-752-8807.
Information in the quality management reports are based on current information in the Ohio Behavior Health (OHBH) system and the Multi-Agency Community Services Information System (MACSIS). OhioMHAS is not responsible for the information in the data systems. If the data systems do not capture ten (10) or more observations in a cell, the report is suppressed. Also, only clients with both admission and discharge records are reported.