Driving with Roadmaps and Dashboards: Using Information Resources to Structure the Decision Models in Service Organizations

Department of Psychology, University of Hawaii at Mānoa, 2430 Campus Road, Honolulu, HI 96822, USA.
Administration and Policy in Mental Health and Mental Health Services Research (Impact Factor: 3.44). 04/2008; 35(1-2):114-23. DOI: 10.1007/s10488-007-0151-x
Source: PubMed


This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

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Available from: Adam Bernstein, Jun 07, 2015
    • "Finally, a substantial number of youths were excluded for psychosis and substance abuse (n=24). Targeting the program for a broader population could be achieved using algorithms to match youths to intervention strategies/modules most appropriate for their clinical presentations and likely treatment adherence patterns (Asarnow, et al., 2005;Chorpita, et al., 2008). Using two therapists created challenges, increased initial costs, but may have reduced treatment duration and later costs by intensifying treatment after the SA. "
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    ABSTRACT: The purpose of this article is to describe feasibility, safety, and outcome results from a treatment development trial of the SAFETY Program, a brief intervention designed for integration with emergency services for suicide-attempting youths. Suicide-attempting youths, ages 11 to 18, were enrolled in a 12-week trial of the SAFETY Program, a cognitive-behavioral family intervention designed to increase safety and reduce suicide attempt (SA) risk (N = 35). Rooted in a social-ecological cognitive-behavioral model, treatment sessions included individual youth and parent session-components, with different therapists assigned to youths and parents, and family session-components to practice skills identified as critical in the pathway for preventing repeat SAs in individual youths. Outcomes were evaluated at baseline, 3-month, and 6-month follow-ups. At the 3-month posttreatment assessment, there were statistically significant improvements on measures of suicidal behavior, hopelessness, youth and parent depression, and youth social adjustment. There was one reported SA by 3 months and another by 6 months, yielding cumulative attempt rates of 3% and 6% at 3 and 6 months, respectively. Treatment satisfaction was high. Suicide-attempting youths are at high risk for repeat attempts and continuing mental health problems. Results support the value of a randomized controlled trial to further evaluate the SAFETY intervention. Extension of treatment effects to parent depression and youth social adjustment are consistent with our strong family focus and social-ecological model of behavior change.
    No preview · Article · Sep 2014 · Journal of Clinical Child & Adolescent Psychology
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    • "Continual feedback is critical, as it may optimize intervention effectiveness. In this manner, the tracking of individual progress, fidelity to protocol, and organizational program results, can be used to inform and maximize the benefits of treatment (Schmidt 2012; Chorpita et al. 2008). Importantly, research suggests that objective feedback may improve child outcomes (e.g. Warren et al. 2009). "
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    ABSTRACT: The Child and Adolescent Functional Assessment Scale (CAFAS) is widely used for outcome management, for providing real time client and program level data, and the monitoring of evidence-based practices. Methods of reliability training and the assessment of rater drift are critical for service decision-making within organizations and systems of care. We assessed two approaches for CAFAS training: external technical assistance and internal technical assistance. To this end, we sampled 315 practitioners trained by external technical assistance approach from 2,344 Ontario practitioners who had achieved reliability on the CAFAS. To assess the internal technical assistance approach as a reliable alternative training method, 140 practitioners trained internally were selected from the same pool of certified raters. Reliabilities were high for both practitioners trained by external technical assistance and internal technical assistance approaches (.909–.995, .915–.997, respectively). 1 and 3-year estimates showed some drift on several scales. High and consistent reliabilities over time and training method has implications for CAFAS training of behavioral health care practitioners, and the maintenance of CAFAS as a global outcome management tool in systems of care.
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    • "Interactive decision dashboards are being increasingly used in business settings [13]. In healthcare, dashboards have been used to advance quality improvement [14-17], medication safety [18], intensive care unit patient management [19], implementation and monitoring of mental health care guidelines [20], and patient wellness [21]. "
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