There’s a significant body of research supporting the effectiveness of Measurement-Based Care (MBC) in raising the standard of mental and behavioral health services. With such positive evidence as a foundation, there’s a fast growing movement towards the adoption of MBC in clinical practice. Many providers and accrediting bodies, like the Joint Commission, recognize that MBC is not simply a nice addition to care, but a fundamental component of delivering high quality mental healthcare.
In most cases, implementing Measurement-Based Care happens at the organizational level, and leaders are often tasked with gaining clinical adoption amongst staff. A team of researchers—including Dr. Sandy Resnick, one of the founding members of the Yale Measurement-Based Care Collaborative—developed a simple 13-step MBC Implementation Planning Guide to support leaders across a variety of mental health settings, as they drive MBC forward at their organization and begin the implementation process with staff and clients.
Below is a summary of the 13 steps outlined in the guide:
Step 1. Identify the setting and participating staff
Determine which staff will participate, as well as which programs, clinics, or services will engage in MBC implementation.
Step 2. Engage and train staff
Ensure all staff complete MBC training, including MBC concepts and interpretation of selected measures.
Step 3. Determine MBC start date
Identify a formal “kick- off” date to increase engagement and enthusiasm.
Step 4. Decide how to engage stakeholders
Thoughtfully engage as many stakeholders as possible, creating conditions for increased buy-in and greater likelihood for long term sustainability.
Step 5. Determine who will be assessed
Identify which populations will receive MBC.
Step 6. Determine measures/frequency
The implementation team should identify specific patient-reported outcome measures (PROMs) to implement based on the patient population and program goals. After measures are selected, determine the frequency of use.
Step 7. Determine administration process
Determine how you will collect your measures, who will administer the assessments, how often, and if they will be administered before, after, or during sessions with clients.
Step 8. Determine method of documentation and ownership
If you’re not using an automated delivery and data collection system like Greenspace, select a standardized tracking system (e.g., spreadsheet, commercially available products) and identify who will enter the data manually.
Step 9. Determine clinical value of MBC
It’s important to move beyond simply collecting data; you must determine how clinicians will use MBC to enhance their practice by promoting shared decision making, and adjusting treatment plans based on assessment results and collaborative discussions with clients.
Step 10. Determine how data will be aggregated and used
Decide which measures will be aggregated, what time points will be reviewed (admission, during treatment, discharge), and the role data will play in quality improvement efforts.
Step 11. Define MBC success
Ensure there is a shared understanding of the clinic/team’s goals with well-defined benchmarks for success.
Step 12. Develop an implementation support plan
Identify ways leadership can continue to support and encourage staff.
Step 13. Determine how to maintain MBC
Develop standard operating procedures, create a sustainability action plan and celebrate the small wins along the way!
Read the full Implementation Planning Guide for more details on this valuable step-by-step approach for organizations and clinics wishing to implement MBC. Remember, when embarking on your MBC journey, it’s okay to do so at a pace that works for your organization. Some organizations opt for a phased approach (for example, a small-scale pilot starting with fewer measures and/or one program stream) and build from there – it doesn’t have to be all or nothing! What’s most important is getting started with a shared commitment to learning, rather than doing it perfectly from the get-go!