California Department of Mental Health

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What is Long Term Care Services (LTCS) doing to Improve the Performance of its Programs?

LTCS embraces the concept of continuous quality improvement. Samples of continuous quality projects are included below.

State Hospital Outcome Evaluation System (SHOES) is designed to answer program evaluation and program-improvement questions for the state hospitals:

  1. What types of problems do patients have in functioning upon their entry to state hospitals?
  2. What sorts of treatments are provided to these patients?
  3. What results are achieved?
  4. At what cost does DMH achieve these results?

The first phase is a demonstration project that will involve gathering and analyzing data at selected programs in each hospital statewide. The purpose will be to get measures working, bugs worked out, data flowing, and a core staff trained and experienced in SHOES. An analysis of the demonstration project data (reliability, validity, feasibility) will be used to plan and implement full statewide deployment, including any staff training and support required, hardware and/or software upgrades, and gaps that may need to be addressed in order to achieve statewide success in SHOES operation. This project is being undertaken entirely with existing resources.

ASH utilizes the Computer Assisted Treatment Planning (CATPA) for treatment team planning with patients. CATPA assists the treatment team in focusing treatment based on the dispositional outcome of the patient utilizing the methods of Bio Psycho-Social Rehabilitation. The computer program then generates the completed treatment plan for inclusion in the record.

The state hospitals each have a continuous performance improvement program in place that strives to improve patient outcomes. Each hospital identifies clinical or administrative issues for performance improvement that would benefit the patients or the hospital. Examples of projects include: reduction of absences without leave (AWOLs), reduction in seclusion and restraint incidents and hours, and streamlining the hiring process.

Metropolitan State Hospital (MSH) has developed a rating scale used to assess patients' current functioning: the Metropolitan Five-Point Scale (M5-PS). The instrument is an "outcome measure" that provides valuable information for individual treatment planning, patient/patient assessment, administrative decision making, and for determining the degree to which MSH is achieving its mission: "To provide mental health services that enhance the quality of life."