Starting January 1, 2018 the Joint Commission requires that accredited Behavioral Healthcare providers…

“[Use the results] to inform goals and objectives identified in individual plans of care, treatment, or services (as needed) as well as to evaluate outcomes of care, treatment, or services provided to the population(s) served.”

After choosing the right tool you’ll need to

“assess outcomes of care, treatment, or services…using a standardized tool or instrument. EP 1 – The organization [must use] a standardized tool or instrument to monitor the individual’s progress in achieving his or her care, treatment, or service goals”

Translation…You need to :

• Pick the right tool(s)
• Devise a schedule for tracking progress that will meet the minimum requirements
• Create and sustain reliable data collection systems
• Establish feedback systems that enable your providers to get results about individual client progress
• Establish feedback systems that aggregate progress for all of your clients so that you can show results
• Develop a system for monitoring to prove that your providers are actually using the feedback systems
• Create systems for documenting that the data informed treatment goals and objectives as well as documenting client progress over time.

SStarting January 1, 2018 the Joint Commission requires that accredited Behavioral Healthcare providers…

“[Use the results] to inform goals and objectives identified in individual plans of care, treatment, or services (as needed) as well as to evaluate outcomes of care, treatment, or services provided to the population(s) served.”

After choosing the right tool you’ll need to

“assess outcomes of care, treatment, or services…using a standardized tool or instrument. EP 1 – The organization [must use] a standardized tool or instrument to monitor the individual’s progress in achieving his or her care, treatment, or service goals”

Translation…You need to :

• Pick the right tool(s)
• Devise a schedule for tracking progress that will meet the minimum requirements
• Create and sustain reliable data collection systems
• Establish feedback systems that enable your providers to get results about individual client progress
• Establish feedback systems that aggregate progress for all of your clients so that you can show results
• Develop a system for monitoring that your providersare actually using the feedback systems
• Create systems for documenting that the data informed treatment goals and objectives as well as documenting client progress over time.

In his slide entitled “Rationale for the Revised Requirement,” Scott Williams, the director of the Department of Health Services Research for the Joint Commission stated:

“The evidence is clear:

• Outcomes were significantly improved across a wide variety of mental health disorders when measurement‐ based care was used.”
• “Without an objective and valid measure of progress, it is difficult to reliably determine which individuals are improving and which are not.”

Scott continued to explain that

“SAMHSA recognizes measurement-based care as an evidence-based practice” and that
“one of the main contributors to poor outcomes is the lack of systematic measurement to determine whether individuals are responding to treatment.”

In other words…your clients make larger clinical gains in a shorter period of time if you are faithful to the procedures.

Frankly, it’s about damned time!

Thank you, Joint Commission, for raising the bar! For several years we’ve been hammering out the needed software and training to make everything easier. After cutting our teeth on the poor early-adopters who hired us before it was required, we’ve got things refined and it’s ready to go. (It does seem unfair that the most progressive folks end up getting the most expensive and clunky systems, doesn’t it? )

At any rate…

We got into this to help providers trim as much of the eye-jabbing monotony of the actual work required to get good data…and then to feed it back to providers with a click. Like we said, it’s tested and tried and less expensive than ever. We also spent a lot of time building tools to track that your people are doing what they are supposed to so that bosses can be confident that everything is running smoothly behind the scenes and that there are no surprises for the next Joint Commission review.

There are 2 levels of service:

1. Full Remote Research Director Service

The full service includes

• Initial consultation
  • Pick the tools
  • Data collection schedules & delivery methods
  • Find the the right people on your team to keep things going
• Implemenation
  • Train data collection personnel
  • Train clinicians how to
    • Use the Remote Research Director Dashboard
    • Identify content for measurable treatment goals (to make it easy to demonstrate how the data influenced care)
    • Log in to track client progress and show data to clients
  • Go live with data collection
• Maintenance
  • A Remote Research Director is dedicated to your account who
    • Checks in weekly to ensure that data are being collected according to expecations
    • Stays in touch with your data collection personnel to provide ongoing training
    • Keeps watching for opportunities to refine systems
• Reporting
  • Monthly reports to executive leadership about how data collection is going and current aggregate outcomes

2. Training and then you are on your own

• Initial consultation
  • Pick the tools
  • Data collection schedules & delivery methods
  • Find the the right people on your team to keep things going
• Implemenation
  • Train data collection personnel
  • Train clinicians how to
    • Use the Remote Research Director Dashboard
    • Identify content for measurable treatment goals (to make it easy to demonstrate how the data influenced care)
    • Log in to track client progress and show data to clients
  • Go live with data collection

1. The Joint Commission knows that this will be challenging AND they aren’t going to lay the hammer down right on January 1, 2018. Don’t get stressed about this and make a bad choice. They are going to accept your good efforts and give you time to get things together if you can show that you are really working toward meeting the requirement.

2. With this new requirement vendors with “standardized tools” are coming out of the woodwork. If you are exploring a vendor who has only one system, that they’ve developed, they will probably tell you that it’s “normed and valid”. There is a science behind this and it can’t happen overnight nor can it happen properly without a lot of time, money and know how. Find a friend who went to graduate school in psychology and ask them to help you make the decision.

Here is what they actually said in the Joint Commission Behavioral Health Conference in October 2017:

• Have well‐established reliability and validity for use as a repeated measure
• Be sensitive to change
• Be appropriate for use as a repeated measure
• Be capable of discriminating between populations that may or may not benefit from services (if appropriate) e.g., clinical/non‐clinical, healthy/non‐healthy functioning, typical/non‐typical, etc.

3. Ask if the tool has a “Reliable Change Index”. The RCI is a statistical mechanism that is designed to determine whether client progress meets clinical significance. Clinical significance refers to “real world & practical” change, not just numbers on a page. Basically, a good RCI will let you know if it’s very likely that a person who knows the client well would recognize improvement.,

4. Ask for evidence that the tools are appropriate for use as repeated measures. Get it in writing…don’t bite on the sales pitch.

5. Our system works with dozens of instrument vendors so that you can assemble a custom package if desired. That said, we’ve pre-picked the highest caliber instruments. (The Joint Commission cited research and used slides from the owners of the tools that we use… just saying.)

6. Some vendors are taking free, open to the public tools, slicing them up and repackaging them as their own system. We can do that too but we think you can do a lot better. Make sure that whomever you use really has been vetted by academic standards.

7. Don’t be tricked by the allure of a short survey. Short surveys simply cannot pack the punch of a larger survey…it’s a matter of science. It’s better to be safe and go with a stronger measure than to fall prey to human nature and seek convenience first.