With its widely recognized, evidence-based approach to improving clinical outcomes, Measurement-Based Care (MBC) provides an opportunity to substantially improve the quality of behavioral health services across North America. As a result of its clear impact on care quality, its adoption is rapidly growing as clinical leaders look to implement and optimize MBC across their services.
Effective MBC implementation will look different at every organization, depending on current measurement processes, program complexity, demographic served, and clinician comfortability with MBC. That being said, there are some universal strategies and tips that can be leveraged as the foundation to any implementation, empowering clinical leaders to ensure MBC fits their organizations unique needs.
Featuring our partners and MBC experts from the Yale Measurement-Based Care Collaborative, Dr. Elizabeth Connors and Dr. Sandy Resnick, this guide provides actionable insights and tips for clinical leaders to customize their MBC implementation and maximize success, ultimately enhancing client engagement and clinical outcomes.
Defining Measurement-Based Care (MBC)
Measurement-Based Care facilitates care by offering a structured approach to treatment that emphasizes routine data collection and the use of client-reported outcome measures throughout care to guide clinical decision making. Embedded within MBC is a collaborative process for clients and clinicians, where results are transparently shared and discussed with clients in order to facilitate joint decision making and enhance therapeutic alliance. By regularly monitoring client symptoms and changes throughout care, MBC enables the early-identification of off track clients and helps inform what treatment adjustments might be necessary to drive clinical outcome improvements.
Dr. Sandy Resnick explains what MBC is and references how it can be applied using the ‘Collect, Share, Act’ framework, which the YMBCC recommends to help foster a collaborative environment throughout treatment.
Engaging in each step of ‘Collect, Share, Act’ is critical to ensuring that you’re engaging in the process of MBC, rather than just collecting data for its own sake. The impact of MBC relies on actually using the outcomes and insights gathered with the client throughout care to improve collaboration, inform treatment discussions, and enhance clinical decision-making. In the clip below, Dr. Resnick offers a breakdown of each step of the ‘Collect, Share, Act’ framework.
Key Principles of an MBC Implementation
When planning your MBC implementation, it’s important to take stock of where your organization is at, what the needs of your staff and clients might be, and assess the best approach to ensuring everyone is supported and empowered throughout your implrmentation Below are some guiding principles to help you get started with your implementation planning, and some important items to consider throughout:
1. Big or Small, Just Get Started Small
Implementing MBC can feel daunting. For some organizations, starting small (e.g. across one service line) can be an effective strategy to gather valuable feedback, build confidence among clinicians, and create a foundation before scaling your MBC practice. This can also look different for every organization; starting small might mean assigning only one assessment to clients, encouraging clinicians to review only one assessment per session, or leveraging MBC within one program. Whether you start small or implement across your entire organization, there will be valuable learnings along the way to inform your current implementation and adjustments to your approach.
2. Empower Your Stakeholders
The success of MBC is positively influenced by the active engagement of key stakeholders throughout the planning process. Involving your care team and clinicians in selecting assessments and designing workflows helps to ensure your plans complement their clinical process. This approach not only fosters enthusiasm but also makes your care team feel integral to the process and decision-making.
To complement existing workflows effectively, it’s essential to provide ongoing training based on their experiences and needs surrounding MBC. This will help continually build competence, boost confidence, and underscores how MBC enhances client care.
3. Remember Your ‘Why’ for MBC
When planning your MBC implementation and introducing it to your team, remember to keep the focus on your organization’s goals and the ‘why’ for MBC. Whether you’re aiming to improve client outcomes, secure funding, or foster a culture of data-driven decision-making, anchoring your efforts in a clear purpose helps to build motivation and engagement. MBC flips the traditional model of measurement on its head by prioritizing, first and foremost, clinical value for clients and clinicians. No matter what your overall goals are, it is important to ensure your team understands that the purpose of your MBC implementation, at its foundation, is focused on providing clinical value for your care team and their clients.
4. Addressing and Overcoming Barriers to MBC
Dr. Connors shares strategies to address potential training opportunities and barriers to MBC implementation within your organization. Proactively identifying and addressing training opportunities or challenges is essential to ensuring your team feels supported and that your implementation stays on track, ultimately driving meaningful improvements in care quality and an impactful MBC process.
5. Tailor and Iterate Your MBC Solutions
It’s important that you tailor your MBC strategy to fit your team’s needs and resources, based on potential challenges you identify. Dr. Connors offers practical examples and strategies to address and tailor your implementation, based on common challenges or needs you might encounter during your planning process.
6. Implementation Success Story: Anne Arundel County Public Schools
Dr. Connors shares the story of Anne Arundel County Public Schools MBC implementation, where implementation occurred gradually over a few years, which allowed the county to build on their success each year and continually iterate and improve their approach.
7. Focus on Individual Data Before Aggregating
If you start your MBC practice with a sole focus on collecting and leveraging individual client outcomes in session you can ensure you’re building a strong foundation for MBC that is focused on improving client care, first and foremost. Once individual workflows are established and your clinicians experience the impact of MBC on their care quality, your strong aggregate organizational dataset can be used for broader insights, organizational planning and quality improvement.
Wrapping up
Measurement-Based Care is not just a framework; it is a clinical process that leads to more effective, client-centred care. By focusing your implementation on ensuring clinical value for clients and clinicians, including and empowering stakeholders throughout the planning process, proactively identifying and addressing training opportunities and implementation challenges, clinical leaders can ensure they’re able to drive meaningful care quality improvements through MBC.
Thank you to Dr. Connors and Dr. Resnick for these valuable insights, which emphasize the importance of strategic planning, clinician engagement, and leveraging data to inform treatment discussions and decisions. With a thoughtful and iterative approach, MBC unlocks transformative care improvements within any behavioral health service setting.
For more details and guidance on planning your implementation, schedule a call with an implementation expert today or reach out anytime at info@greenspacehealth.com. You can also explore the YMBCC’s implementation guide and checklist and read our summary of their guide for more information.
