Patient Feedback Effectiveness Study

描述(由申请人提供)： 质量改进(QL)方法是整个美国商业和医疗管理的基石，但关于成瘾治疗环境中的QL干预的研究很少。这项拟议的研究测试了一个QL系统--患者反馈(PF)--在增加门诊团体治疗出勤率和自我报告戒酒方面的有效性。PF的可行性和可接受性是在国家药物滥用治疗临床试验网络内进行的六个地点的研究中确定的。在这项拟议的研究中，32个以社区为基础的门诊治疗项目将与大约250名临床医生随机分配到PF或常规临床实践中。在PF状态下，每隔一周，临床患者被邀请完成一项包含12个项目的自我管理调查，在调查中他们对治疗联盟和治疗满意度进行评级，并报告过去一周的药物使用情况。这些匿名调查由诊所工作人员传真到宾夕法尼亚大学的一个数据中心，在那里，一个定制软件应用程序将调查转换为反馈报告，并将它们发布到一个受密码保护的网站上。临床医生可以访问他们的工作量反馈报告和整个诊所的汇总报告；主管只能访问汇总的临床报告。每个月，工作人员以团队形式开会，审查反馈报告，并制定旨在改善选定质量指标的质量控制计划。PF网站和PF每月电子通讯为参与的临床医生提供社会认可、临床资源和虚拟社区。20周后，两种情况下的参与者都完成后续措施，然后两组都可以开放使用PF，再延长12个月。在“可持续发展阶段”，监测工作人员对PF网站的使用情况。在可持续性研究期间引入了PF调查的替代版本，包括监测艾滋病毒危险行为的版本和由参与网站的工作人员合作开发的版本。调查的快速处理使诊所工作人员能够获得近乎实时的反馈。组织可以与资金来源、监管机构、政策制定者和其他利益相关者共享反馈报告。这种集中式、半自动的反馈系统简化了认证要求的满足，从而降低了诊所运营的成本。宾夕法尼亚大学的Bob Forman博士正在为这项PF测试提交合作临床试验申请。

DESCRIPTION (provided by applicant): Quality improvement (Ql) methods are a cornerstone of business and healthcare management throughout the United States yet there have been few studies of Ql interventions in addiction treatment settings. The proposed study tests the effectiveness of one Ql system - Patient Feedback (PF) - at increasing outpatient group therapy attendance and self-reported abstinence. The feasibility and acceptability of PF was established in a six-site study conducted within the National Drug Abuse Treatment Clinical Trials Network. In the proposed study, 32 community-based outpatient treatment programs with approximately 250 clinicians will be randomly assigned to PF, or usual clinic practices. In the PF condition, every other week clinic patients are invited to complete a 12-item, self-administered survey in which they rate therapeutic alliance and treatment satisfaction, and report past week substance use. These anonymous surveys are faxed by clinic staff to a University of Pennsylvania data center where a custom software application converts the surveys into feedback reports and posts them to a password protected website. Clinicians can access their caseload feedback reports and aggregated reports for the whole clinic; supervisors can only access the aggregated clinic reports. On a monthly basis staff meet as a team to review the feedback reports and develop Ql plans intended to yield improvements in select Ql indicators. The PF website and the monthly PF e-newsletter provide social recognition, clinical resources, and a virtual community for participating clinicians. After 20-weeks, participants in both conditions complete follow-up measures and then both groups are given open access to PF for 12 additional months. During "sustainability phase" staff usage of the PF website is monitored. Alternate versions of the PF Survey are introduced during the sustainability study, including one that monitors HIV risk behavior and one developed collaboratively by staff from the participating sites. The rapid processing of surveys enables near real time feedback to clinic staff. Organizations may share their feedback reports with funding sources, regulatory agencies, policy makers, and other stakeholders. This centralized, semi-automated feedback system eases fulfillment of accreditation requirements and as such, reduces the cost of clinic operations. A collaborating clinical trial application for this test of PF is being submitted by Bob Forman, PhD, from University of Pennsylvania.