Outcomes: Developing Pathways to Quality Care
by Dr. Bob Lynn
Chief Clinical Advisor, Origins Behavioral HealthCare
Outcomes are an important part of a multi-faceted treatment planning process. They are one spoke on the wheel along with research, clinical judgment, client feedback, clinical supervision, aggregated client data, context, and spirituality, as well as case management, being equally important in driving quality care. The integration of the above can create the basis for establishing a treatment program and evolving a gold standard care system. The major value of outcomes should be to inform care.
Outcomes research focuses on the client’s treatment process. When outcome data supports treatment and provides the evidence needed by clinicians to make informed decisions, everyone benefits. There must be an ongoing effort to utilize data to bridge the gap between outcomes research and practice.
In medically-related fields, outcomes have been the vehicle that informs practice, while in addiction treatment outcomes have taken on many different meanings for clinicians. Addiction treatment providers must be educated concerning the relationship of outcome measures to practice and methods of incorporating theoretical approaches to treatment supported by credible data.
Outcomes which are developed within a research paradigm are best suited to inform care. The gold standard of a double blind randomized methodology is not required to render the data useful. Most importantly is that whatever standard is used, it is driven by scientific rigor. It is this type of outcomes data that may inform care, create new or improved practice protocols or reject worn systems as being ineffectual. This data can help a program to evolve and continually update theory and practice. Similarly this information can be cost effective in better utilizing finite resources and producing improved treatment results. Unfortunately some treatment programs shy away from this type of investigation for fear of not meeting perceived treatment outcome goals. A shift in perception from rating programs to using data to inform treatment systems may alleviate some of these concerns and barriers to research.
The field needs to move toward treatment programs providing services that are outcome based both on the program and client levels. These programs are represented by a professional staff that is able to provide individualized care supported by the client’s clinical presentation. Data is mined to develop best practice guidelines and client-driven care. The ability to combine client presentation, aggregate program data and research in developing care plans is the standard toward which the addictions treatment community needs to aim.
