Applying utilization review procedures in a community mental health center.

A large, multiservice community mental health center operates a utilization review program based on a three-level system of chart review by medical records personnel, a utilization review technician, and a committee of clinicians. Review is facilitated by a checklist for use in rating such issues as comprehensiveness, coordination, and quality of care aginst standards of care developed by the director of each service. The incompleteness of charts pulled for review is a continuing problem. But the system makes for efficient review and has various secondary benefits, such as the improvement of medical records. A survey made in the first year showed that staff had mixed feelings about the need for review, but that 60 per cent thought it was helpful all or most of the time.