Lemke Sonne, Boden Matthew Tyler, Kearney Lisa K, Krahn Dean D, Neuman Matthew J, Schmidt Eric M, Trafton Jodie A
Program Evaluation and Resource Center, Veterans Affairs Palo Alto Health Care System.
United States Department of Veterans Affairs, Office of Mental Health Operations.
Psychol Serv. 2017 Feb;14(1):1-12. doi: 10.1037/ser0000097.
We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record
我们概述了心理健康领域的发展情况，该领域旨在追踪美国退伍军人健康管理局（VHA）心理健康护理的可及性和质量，是一个基础广泛的绩效评估系统的一部分。该领域通过针对地区和机构领导层，为他们提供一种简洁而全面的衡量标准，以识别在心理健康项目中面临挑战的机构，从而为国家绩效改进工作增添了一个重要元素。我们介绍了衡量标准选择和制定背后的概念框架及基本原理。心理健康领域涵盖心理健康治疗的三个重要方面：人群覆盖、护理连续性和护理体验。每个组成部分都是现有和新调整措施的综合，具有中等到高度的内部一致性；各组成部分在统计上相互独立或有适度关联。心理健康领域的开发和传播涉及多种方法，并得益于地方、区域和国家领导层之间的密切合作以及与现有质量改进举措的协调。在使用的第一年，各机构在变化的方向和程度上存在差异。这些变化模式总体上与定性信息一致，为该领域及其组成衡量标准的有效性提供了支持。随着VHA心理健康系统和潜在数据资源不断发展，衡量标准的维护仍是一个迭代过程。随着心理健康护理的整合并在医疗系统中日益融合，所吸取的经验教训可能对更广泛的心理健康服务提供者群体有所帮助。（PsycINFO数据库记录）
