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Quality Assurance in Psychiatry: Concept and Methods

Published online by Cambridge University Press:  16 April 2020

W Gaebel*
Affiliation:
Department of Psychiatry, University of Düsseldorf, Bergische Landstrasse 2, D-40629 Düsseldorf, Germany
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Summary

Quality assurance is the corrective action applied to any observed discrepancy between optimal and actual level of medical care requiring continuous quality control. Obviously, quality assurance is of utmost importance also in psychiatric practice. Quality care as defined by the degree of adherence to standards and guidelines can be measured in terms of structural, process and outcome indicators applied to inpatient, outpatient and complementary services. To promote the implementation of practice guidelines into psychiatric care conceptual, methodological, and organisational requirements must be taken into account.

Type
Symposia

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References

American Medical Association Council on medical service. Quality of care. JAMA 1986; 256: 10321034CrossRefGoogle Scholar
American Psychiatric Association (APA) Task Force. Guidelines for psychiatric practice in community mental health centers. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 215218Google Scholar
American Psychiatric Association (APA). Practice Guideline for Eating Disorders. Washington, DC: APA, 1993Google Scholar
American Psychiatric Association (APA). Practice Guideline for Major Depressive Disorder in Adults. Washington, DC: APA, 1993Google Scholar
American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 4th ednWashington, DC: APA, 1994 (DSM-IV)Google Scholar
American Psychiatric Association (APA). Practice Guideline for Treatment of Patients with Bipolar Disorder. Washington, DC: APA, 1995aGoogle Scholar
American Psychiatric Association (APA). Practice Guideline for Treatment of Patients with Substance Use Disorders, Alcohol, Cocaine, Opioids. Washington, DC: APA, 1995bGoogle Scholar
Andrews, SVaughan, KHarvey, Ret al.A survey of practising psychiatrists' views on the treatment of schizophrenia. Br J Psychiatry. 1986;149:357364CrossRefGoogle ScholarPubMed
Antoni, CHQualitätszirkel als Modell partizipativer Gruppenarbeit. Bern, Stuttgart, Toronto: Verlag Hans Huber, 1990Google Scholar
Arbeitsgemeinschaft Cochrane Collaboration. Die Cochrane Collaboration. Schweizerische Arztezeitung 1996;77 (3):117120Google Scholar
Arbeitsgemeinschaft Wissenschaftlicher Medizinischer Fachgellssechaften. (AWMF) ‘Leitlinien’. Düsseldorf:1995Google Scholar
Armstrong, MSAndrews, GA survey of practising psychiatrists' views on treatment of the depressions. Br J Psychiatry 1986; 149: 742750CrossRefGoogle ScholarPubMed
Awad, AIntegrating a clinical review process with postgraduate training in clinical psychopharmacology. Qual Rev Bull 1987; 13: 279282CrossRefGoogle ScholarPubMed
Awad, AQuality of life of schizophrenic patients on medications and implications for new drug trials. Hasp Community Psychiatry 1992; 43: 262265Google ScholarPubMed
Baur-Felsenstein, MQualitätssicherung aus der Sicht der Selbstverwaltung. Arzt Krankenhaus 1994; 1: 2428Google Scholar
Berger, MDer neue Facharzt für Psychiatrie und Psychotherapie. Spektrum 1993; 22: 49Google Scholar
Bertolote, JMQuality assurance in mental health care. Sartorius, NDe Girolamo, GAndrews, GGerman, GAEisenberg, LTreatment of Mental Disorders. A Review of Effectiveness. Washington, DC, London: WHO, American Psychiatric Press Inc, 1993; 443461Google Scholar
Bertolote, JMQuality Assurance in Mental Health Care. Geneva: Division of Mental Health, WHO, 1994Google Scholar
Böhme, KCording, CRitzel, GSpengler, ATrenckmann, UThesen zur Qualitätssicherung (QS). Spektrum Psychiatrie Nervenheilkunde 1994; 23: 5862Google Scholar
Buchborn, EDer Ärztliche Standard. Dtsch Ärzteblatt. 1993;90(28/29):B1446B1449Google Scholar
Bundesarbeitsgemeinschaft (BAG) der Träger Psychiatrischer Krankenhäuser. Zielsezzungs-und Orientierungsdaten psychiatrischer Krankenhäuser.Cologne: Landschaftsverband Rheinland, 1990Google Scholar
Bundesarbeitsgemeinschaft (BAG) der Leitenden Ärzte kinder-zund jugendpsychiatrischer Kliniken und Abteilungen. Entwurf für ein Konzept zur Qualitätssicherung im Kinder-zund Jugendpsychiatrischen Krankenhaus (Stand 7/1993). Unveroffentlichtes Manuskript, 1993aGoogle Scholar
Bundesarbeitsgemeinschaft (BAG) der Leitenden Ärzte kinder-zund jugendpsychiatrischer Kliniken und Abteilungen. Zielsetzungsund Orientierungsdaten Kinder- und Jugendpsychiatrischer Kliniken und Abteilungen. Cologne: Landschaftsverband Rheinland, 1993bGoogle Scholar
Bundesgesetzblatt (BGBl). Verordnung über Maßstäbe und Grundsätze für den Per sonalbedarf in der stationären Psychiatrie (Psychiatrie-Personalverordnung — Psych-PV). Bundesgesetzblatt 1990; I (suppl):29302939Google Scholar
Cahn, CRichman, AQuality assurance in psychiatry. Can J Psychiatry 1985; 30: 148152CrossRefGoogle Scholar
Clements, CDBonacci, DYerevanian, Bet al.Assessment of suicide risk in patients with personality disorder and major affective diagnosis. Qual Rev Bull 1985; 11: 150154Google ScholarPubMed
Cole, JOKatz, DLDrug therapy monitoring in a private psychiatric hospital: a consideration of its risks and benefits. McLean Hospital Journal 1988; 13: 114157Google Scholar
Collins, JFEllsworth, RBCasey, NAet al.Treatment characteristics of effective psychiatric programs. Hosp Community Psychiatry 1984; 35: 601605Google ScholarPubMed
Cording, CBasisdokumentation und Ergebnisqualität. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 173181CrossRefGoogle Scholar
Cording, CGaebel, WSpengler, Aet al.Die neue psychiatrische Basisdokumentation. Eine Empfehlung der DGPPN zur Qualitätssicherung im(teil-)stationären Bereich. Spektrum Psychiatrie Nervenheilkunde 1995; 1: 341Google Scholar
Craig, TJMehta, RMClinician-computer interaction: automated review of psychotropic drugs. Am J Psychiatry. 141 1984 267270Google ScholarPubMed
Deutsche Gesellschaft für Suizidprävention (DCS). Leitlinien zur Organisation von Krisenintervention. Harsum: Köhler, 1993Google Scholar
Deutscher Ärztetag. Gesundheitspolitisches Programm der deutschen Ärzteschaft (Blaues Papier).Dtsch Ärzteblatt. 1994;24(suppl):142Google Scholar
Deutsches Institut für Normung (DIN). e.V. Qualitätssicherung und angewandte Statistik. Verfahren 3: Qualitätssicherungssysteme. DIN-Taschenbuch 226. Berlin, Cologne: Beuth, 1992Google Scholar
Dilling, HBalck, FBosch, Get al.Zur psychiatrischen Basisdokumentation. Nervenarzt. 54 1983;262267Google Scholar
Dilling, HMombour, WSchmidt, MHInternationale Klassifikation psychischer Storungen (ICD-10). Bern, Göttingen, Toronto: Hans Huber, 1992Google Scholar
Donabedian, AEvaluating the quality of medical care.Milbank Mem Fund Q. 1966;44:166CrossRefGoogle ScholarPubMed
Donabedian, AExplorations in Quality Assessment and Monitoring. Vol II: The Criteria and Standards of Quality. Ann Arbor: Health Administration Press, 1982Google Scholar
Donabedian, AThe quality of care: how can it be assessed?. JAMA. 1988;260:17431748CrossRefGoogle ScholarPubMed
Eichhorn, SKrankenhausbetriebslehre. Theorie und Praxis der Krankenhaus-Leistungsrechnung. Band III. Stuttgart, Berlin, Mainz: Verlag W Kohlhammer, 1987Google Scholar
Ellis, JMulligan, IRowe, JSaccett, DIInpatient general medicine is evidence based. Lancet 1995; 346: 407410Google ScholarPubMed
Fauman, MAQuality assurance monitoring in psychiatry. Am J Psychiatry 1989; 146: 11211130Google Scholar
Fauman, MAMonitoring the quality of psychiatric care. Psychiatr Clin North Am 1990; 13: 7388CrossRefGoogle ScholarPubMed
Fifer, WRQuality assurance in health care. Awad, AGDurost, HBMcCormick, WOEvaluation of Quality of Care in Psychiatry. Toronto, Oxford, New York, Sydney, Paris, Frankfurt: Pergamon Press, 1980Google Scholar
Gaebel, WQualitätssicherung diagnostischer und therapeutischer Maßnahmen im psychiatrischen Krankenhaus. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 87108CrossRefGoogle Scholar
Gaebel, WQualitätssicherung in der Psychiatrie. Nervenarzt. 66 1995 481493Google Scholar
Gesetz zur Strukturreform im Gesundheitswesen (Gesundheits-Reformgesetz -GRG). Bundesgesetzblatt 1988;1(62):24772604Google Scholar
Gesetz zur Sicherung und Strukturverbesserung der gesetzlichen Krankenversicherung (Gesundheitsstrukturgesetz — GSG). Bundesgesetzblatt 1992;1(59, suppl):2266–2334Google Scholar
Goldner, EMBilsker, DEvidence-based psychiatry. Can J Psychiatry. 1995;40:97101Google ScholarPubMed
Grawe, KDonati, RBernauer, FPsychotherapie im Wandel — von der Konfession zur Profession. Göttingen: Hogrefe, 1994Google Scholar
Gray, SHQuality assurance and utilization review of medical psychotherapies. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 153159Google Scholar
Grimshaw, JMRussell, ITEffect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet 1993; 342: 13171322CrossRefGoogle ScholarPubMed
Häfner, Han der Heiden, WThe evaluation of mental health care systems. Mezzich, JEJorge, MRSalloum, IMPsychiatric Epidemiology. Assessment Concepts and Methods. Baltimore, London: Johns Hopkins University Press, 1994; 494504Google Scholar
Hamilton, JMIntroduction to the American Psychiatric Association's involvement in quality assurance and utilization review. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 79Google Scholar
Helmchen, HHippius, HMüller-Oerlinghausen, BRüther, EArznei-mittel-Überwa chung in der Psychiatrie. Nervenarzt. 56 1985 1218Google Scholar
Kaltenbach, TQualitätsmanagement im Krankenhaus. Melsungen: Bibliomed Medizinische Verlagsgesellschaft mbH, 1991Google Scholar
Kane, JMEvans, DLFiester, SJet al.Psychopharmacological screening criteria. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 189205Google Scholar
Kelstrup, ALund, KLauritsen, BBech, PSatisfaction with care reported by psychiatric inpatients. Acta Psychiatr Scand 1993; 87: 374379CrossRefGoogle ScholarPubMed
Kibbee, PThe suicidal patient (an issue for quality assurance and risk management. J Nurs Qual Assur 1988; 3: 6371Google ScholarPubMed
Kissling, WGuidelines for Neuroleptic Relapse Prevention in Schizophrenia. Berlin, Heidelberg, New York: Springer-Verlag, 1991CrossRefGoogle Scholar
Klieser, ELehmann, EStrauß, WHÄrztliche und psychiatrische Weiterbildung als Mittel und Aufgabe der Qualitätssicherung. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 6675CrossRefGoogle Scholar
Kunze, HKaltenbach, LPsychiatrie-Personalverordnung. Textausgabe mit Materalien und Erläuterungen für die Praxis. Stuttgart: Kohlhammer GmbH, 1994Google Scholar
Leimkühler, AMDie Qualität klinischer Versorgung im Urteil der Patienten. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 163172CrossRefGoogle Scholar
Linden, MTherapeutic Standards in psychopharmacology and medical decision-making. Pharmacopsychiatry 1994;27(suppl):4145CrossRefGoogle ScholarPubMed
Liptzin, BQuality assurance and psychiatric practice (a review. Am J Psychiatry 1974; 131: 13741377CrossRefGoogle ScholarPubMed
Liptzin, BQuality assurance and treatment outcome: a medical perspective. Mirin, SMGossett, JTGrob, MCPsychiatric Treatment. Advances in Outcome Research. Washington, DC, London: American Psychiatric Press Inc, 1991; 265278Google Scholar
Mattson, MRQuality assurance: a literature review of a changing field. Hosp Community Psychiatry 1984; 35: 605616Google ScholarPubMed
Mattson, MRGeneric quality screens (psychiatric. Developed by the Health Care Financing Administration for use by peer review organizations. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 207213Google Scholar
Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992Google Scholar
Miller, SIPhillips, KLChemical dependency disorders: Guidelines for review of inpatient therapy and rehabilitation. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 161166Google Scholar
Moak, GSImproving quality in psychogeriatric treatment. Psychiatr Clin North Am 1990; 13: 99112CrossRefGoogle ScholarPubMed
Möller, HJDeister, ALaux, GOutcome-Forschung als Mittel der Qualitätssicherung. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 147162CrossRefGoogle Scholar
Molnar, GFeeney, MGComputer-assisted review of antipsychotics on acute care units. Qual Rev Bull 1985; 11: 271274Google ScholarPubMed
Müller-Oerlinghausen, BEntwurf eines Lemzielkatalogs der Psychopharmakologie für Ärzte mit der Fachbezeichnung “Psychiatrie”. Part I. Spektrum 1993; 22: 146150Google Scholar
Müller-Oerlinghausen, BEntwurf eines Lernzielkatalogs der Psychopharmakologie für Ärzte mit der Fachbezeichnung “Psychiatrie”. Part II. Spektrum 1993; 22: 177181Google Scholar
Munich, RLQuality assurance and quality of care. I. Finding the linkages. Psychiatr Hosp 1990; 21: 1324Google ScholarPubMed
Munich, RLHurley, BOelaney, JQuality assurance and quality of care. II. Monitoring treatment. Psychiatr Hosp 1990; 21: 7177Google ScholarPubMed
Naylor, DGrey zones of clinical practice: some limits to evidence-based medicine. Lancet 1995;345 (4):840842CrossRefGoogle ScholarPubMed
Prunier, PBuongiorno, PAGuidelines for acute inpatient psychiatric treatment review. Gen Hosp Psychiatry 1989; 11: 278281CrossRefGoogle ScholarPubMed
Rössler, WSalize, HJQualitätsindikatoren psychiatrischer Versorgungssysteme. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 3951CrossRefGoogle Scholar
The Royal Australian and New Zealand College of Psychiatrists. The Quality Assurance Project: a methodology for preparing ‘ideal’ treatment outlines in psychiatry. Austr NZ J Psychiatry 1982; 16: 153158CrossRefGoogle Scholar
Rush, AJClinical practice guidelines. Good news, bad news, or no news?. Arch Gen Psychiatry 1993; 50: 483490CrossRefGoogle ScholarPubMed
Schaub, RTQuality assurance in psychiatric care (the example of routine use of the AMDP system. Pharmacopsychiat 1994:27(suppl):4650CrossRefGoogle ScholarPubMed
Schröder, MAuswirkungen des GSG auf das Informationsmanagement und die Krankenhausinformatik. Das Krankenhaus 1993; 10: 460470Google Scholar
Schyve, PMPrevost, JAFrom quality assurance to quality improvement. Psychiatr Clin North Am 1990; 13: 6172CrossRefGoogle ScholarPubMed
Sederer, LIQuality, cost, and contracts: administrative aspects of inpatient care. Sederer, LIInpatient Psychiatry. Diagnosis and Treatment. Baltimore. Hong Kong, London: Williams & Wilkins, 1991; 419431Google Scholar
Selbmann, HKKonzept und Definition medizinischer Qualitätssicherung. Gaebel, WQualitätssicherung im psychiatrischen Krankenhaus. Vienna: Springer, 1995; 310CrossRefGoogle Scholar
Smith, APDesign a clinical information system. Br Med J 1992; 305: 415417CrossRefGoogle ScholarPubMed
Strauss, JSCarpenter, WTPrediction of outcome in schizophrenia. III. Five-year outcome and its predictors. Arch Gen Psychiatry 1977; 34: 159163CrossRefGoogle ScholarPubMed
Taylor, DThe joint commission quality assessment and improvement model. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committeeon Quality Assurance. Washington, DC: APA, 1992; 6977Google Scholar
Van Vort, WMattson, MRA strategy for enhancing the clinical utility of the psychiatric record. Hosp Community Psychiatry 1989; 40: 407409Google ScholarPubMed
Way, BBBraff, JSteadman, HJConstructing an efficient inpatient incident reporting system. Psychiatr Q 1985; 57: 147152CrossRefGoogle ScholarPubMed
Weiner, RDAPA Task Force on ECT. Electroconvulsive therapy guidelines and criteria. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 181187Google Scholar
Wilson, GFDefining and measuring quality. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 1921Google Scholar
Wilson, GFPhillips, KLEating disorders: quality assurance and utilization review guidelines. Mattson, MRManual of Psychiatric Quality Assurance. A Report of the American Psychiatric Association Committee on Quality Assurance. Washington, DC: APA, 1992; 167172Google Scholar
Wing, JBrewin, CRThomicroft, GDefining mental health needs. Thomicroft, GBrewin, CRWing, JMeasuring Mental Health Needs. Gaskell, London: Royal College of Psychiatrists, 1992; 117Google Scholar
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