Implementing quality management in psychiatry: from theory to practice--shifting focus from process to outcome.

With the increasing emphasis on the satisfaction of patient-clients balanced by the need for cost-efficient treatment, quality management is an ever-increasing concern for mental health care providers. It is now apparent that psychiatrists must follow treatment progress and outcome to assess and improve the quality of the care they provide. Most quality measurement and management programs to date have been carried out in research settings using process measures; however, it is clear that the focus must shift from research to practice and from process to outcome measurements. We discuss the notion of quality and outcome management and propose a model for selecting outcome measures. This model suggests 5 dimensions that are commonly assessed in outcome management. We successfully implemented a computerized documentation and quality measurement system in a psychiatric outpatient setting.