Incentives and Alerts for Improving Performance in Washington State

描述(由申请人提供)：华盛顿州改善绩效的激励措施和警报有关治疗过程措施(例如，启动、参与和持续护理措施)的信息可能对专门的药物滥用治疗计划有用，以跟踪其绩效并针对质量改进努力的领域。华盛顿州行为健康与康复分部(DBHR)将合作研究两种干预措施--经济激励措施和针对客户的警报系统--对项目绩效和客户结果的影响。特定于客户端的警报将是对该州已存在的数据系统的增强。这些警报将重点放在门诊、强化门诊、戒毒和住院项目上，每周向项目提供有关可能未达到建议服务水平的特定客户的信息，以便项目能够跟踪这些客户，以提高他们的绩效指标。拟议的设计将华盛顿州的项目随机分为以下研究组：A组(控制组)、B组(仅激励组)、C组(仅警报组)、D组(激励和警报组)。还将审查这两种干预措施对可能出现健康差距的亚群(例如，种族/族裔少数群体或农村人口)的护理质量的不同影响。最后，将探讨服务对象和治疗方案特征对激励和警报系统影响的影响。具体目标如下：1.考察是只提供激励还是提供 特定于客户的警报只会改善程序性能和客户结果。2.检查特定于客户的警报与激励相结合是否在计划绩效和客户结果方面带来了比仅激励或仅警报更多的改进。3.探索是否存在仅激励、仅警报或激励加警报对子群(例如，种族/少数民族和农村客户)的计划绩效的不同影响。4.评估客户和程序级别的因素是否与程序实现和保持良好性能的能力相关。

DESCRIPTION (provided by applicant): Incentives and Alerts for Improving Performance in Washington State Information on treatment process measures (e.g. initiation, engagement, and continuity of care measures) can be useful to specialty substance abuse treatment programs for tracking their performance and targeting areas for quality improvement efforts. The Washington State Division of Behavioral Health and Recovery (DBHR) will collaborate to study the impacts of two interventions, financial incentives and a client-specific alert system, on program performance and client outcomes. Client-specific alerts will be an enhancement to the data systems that are already in place in the state. Focusing on outpatient, intensive outpatient, detoxification, and residential programs, the alerts will provide programs with information, on a weekly basis, regarding specific clients who may not be meeting recommended levels of services so programs will be able to follow up with these clients with the goal of improving their performance measures. The proposed design will randomize programs in Washington State into the following study groups: Group A (Control Group), Group B (Incentives Only Group), Group C (Alerts Only Group) Group D (Incentives and Alerts Group). The differential impacts of these two interventions on the quality of care for subpopulations that may experience health disparities (e.g., racial/ethnic minorities or rural populations) will also be examined. Finally, the influenceof client and treatment program characteristics on the impacts of incentives and alert systems will be explored. The specific aims are as follows: 1. Examine if offering incentives only or providing client-specific alerts only leads to improved program performance and client outcomes. 2. Examine if client-specific alerts in combination with incentives lead to additional improvement in program performance and client outcomes beyond that of incentives only or alerts only. 3. Explore if there are differential impacts of incentives only, alerts only, or incentives plus alert on program performance by subpopulations (e.g., racial/ethnic minorities and rural clients). 4. Evaluate if client and program level factors are associated with programs' ability to achieve and maintain good performance.