From PORT to Policy to Patient Outcomes: Crossing the Quality Chasm

New York State Psychiatric Institute, Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
Schizophrenia Bulletin (Impact Factor: 8.45). 12/2009; 36(1):109-11. DOI: 10.1093/schbul/sbp142
Source: PubMed
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Available from: Harold Alan Pincus, Oct 02, 2015
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    • "There are many reasons for the disconnection between science and practice; among these a lack of funding and confused lines of authority and organization for planning, budgeting, prioritizing, and implementing services are prominent. The consequences of organizational disarray include lack of access to skilled mentoring and monitoring, inadequate training, inadequate assessment, uncoordinated planning, and lack of financial provisions [63, 64]. Government policies and the manner in which they are implemented often support practices that foster institutional care and incarceration, rather than providing incentives and support for the implementation of comprehensive programs community-based treatment programs. "
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    ABSTRACT: Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009). The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized.
    04/2013; 2013:792769. DOI:10.1155/2013/792769
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    Nordic journal of psychiatry 10/2010; 64(5):291-2. · 1.34 Impact Factor
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    ABSTRACT: Evidence-based clinical guidelines are developed to educate and inform physicians about best practices in patient care, and assist providers in the application of treatments and technologies that can improve outcomes. Clinical guidelines also aid appeal of payment decisions; serve as the basis for quality measure development, appropriateness criteria, and maintenance of certification modules; and help identify areas for further clinical research. For guidelines to serve dermatologists effectively in these diverse roles, they must be current, varied in clinical focus, and developed with a high degree of rigor that includes attention to potential conflicts of interest. To address these needs and keep pace with advances in medicine, the American Academy of Dermatology (AAD) recently revised the evidence-based guideline development process. Key changes include development of a yearly needs assessment process to determine what guidelines are most needed, the development of focused guidelines that address rapidly evolving clinical topics, a formal method of vetting guidelines produced by other societies, and a scheduled reassessment of existing guidelines to ensure they provide current and practical information. The process for identifying and managing potential conflicts of interest was also revised and expanded to meet current expectations and evolving standards. The impact of these changes to the AAD's guideline development process will not be fully realized for several years. These changes will help ensure the AAD will be able to provide its members with continued evidence-based guidance to support patient care across the scope of dermatologic practice.
    Journal of the American Academy of Dermatology 06/2011; 64(6):e105-12. DOI:10.1016/j.jaad.2010.10.029 · 4.45 Impact Factor
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