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Measuring Consumer Perception of Care

Measuring Consumer Perception of Care. Challenges & Opportunities John Bartlett, M.D.,M.P.H. March 20-21 Meeting with California’s Division of Alcohol and Drug Programs. Goals for Presentation. Review consumer perception of care as a concept Review success criteria for its measurement

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Measuring Consumer Perception of Care

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  1. Measuring Consumer Perception of Care Challenges & Opportunities John Bartlett, M.D.,M.P.H. March 20-21 Meeting with California’s Division of Alcohol and Drug Programs

  2. Goals for Presentation • Review consumer perception of care as a concept • Review success criteria for its measurement • Review the development & testing of CSAT’s Modular Survey

  3. The Concept • Measuring consumer response = core business function • In healthcare tied to growth of consumerism & CQI initiatives • A NOMS domain • Consumer perception of care ≠ satisfaction

  4. Measuring Consumer Perception of Care • Approaches to measurement differ depending on scope & purpose • For purposes of comparability, improvement over time, & benchmarking measures must be : • Meaningful • Scientifically-sound • Actionable

  5. The Problems with Satisfaction • No evidence linking the measurement of satisfaction to client outcomes • Few satisfaction surveys scientifically validated • Data is not actionable (ceiling effect)

  6. The Modular Survey • SAMHSA –supported initiative • Conducted under the auspices of the Forum on Performance Measurement & the Washington Circle • Conducted in 2 phases • Phase 1 in conjunction with mental health Rx • Phase 2 substance abuse – specific

  7. Design Requirements • Phase 1 focus on commonality, not comprehensiveness • Short • Scientifically sound • Actionable • Use of existing, widely-used, non-proprietary surveys • Consensus-driven

  8. Modular Survey Flow of Common Questions for Individual Respondent Common Design Template Adult Mental Health Core Measures Adult Common Measures Adult Substance Abuse Core Measures “Field-level” Common Measures C/Adol Mental Health Core Measures Child/ Adolescent Common Measures Adol Substance Abuse Core Measures

  9. Approach to Phase 1 • 4 workgroups to develop consensus • Selection of instruments • Identification of concerns • Identification of potential items • Ranking of items • Final item selection (modified Delphi) • Pilot testing

  10. Phase 1 Pilot Testing • Conducted during summer/fall 2004 • Primary data collection in Cincinnati United Way agencies (N = 1157) • Secondary analysis using MHSIP data (16 state & LA County data sets) • Final N > 22,000 respondents • Pool of items reduced from 28 to 11 • All items common to both fields, both populations

  11. Approach to Phase 2 • Stand-alone SUD Rx initiative • Under Washington Circle with Forum as “subcontractor” • New item development (no existing SUD survey) • Content work group co-chaired by Tom McLellan (TRI) & Doreen Cavanaugh (Georgetown) • Support from Forum Methods Work Group & Ann Doucette (George Washington • Public Provider & Consumer Advisory Groups

  12. Phase 2 SUD Initiative • Closely coordinated with NOMS • Identification of concerns • Relationship to treatment program • Self awareness of problem/commitment to change • Perceived outcomes • Social connectedness • Generation of items (35 in testing pool)

  13. Phase 2 Pilot Testing • OMB & IRB approval spring 2006 • Conducted in 3 rounds • Round 1 – Adult & Adolescent (summer 2006) • 14 programs, N = 1207 • Round 2 – Adult & Adolescent (winter 2006 – 07) • 6 programs, N = 585 • Round 3 – Adolescent (spring-summer 2007) • 8 programs, N = 268 • Final adult N = 1549 (2 samples) • Final adolescent N = 492 (1 sample) • All demographic groups covered except Native American

  14. Phase 2 Completion • Analysis & recommendations by Ann Doucette PH.D. • Use of IRT • For a copy of the technical report, e-mail jbartlett@avisagroup.com • Review by Forum Methods Work Group (November 2007) • Review & Approval by SUD Content Committee (November 2007)

  15. Final SUD Modular Survey • 21 items (11 from Phase 1, 10 from Phase 2) • Quality – 6 items • Perceived Outcomes – 6 items • Social Connectedness – 7 items • Commitment to Change – 2 items • 10 demographic & background items • Spanish translation available

  16. Modular Survey Flow of Common Questions for Individual Respondent Final Version Phase 2 Mental Health Items Phase 1 Common Items * Phase 2 SUD Items Common Design Template * All populations, all fields

  17. Convergence with NOMS • In Spring 2006 NOMS Technical Consulting Group convened • Recommended 17 items from 8 different instruments • 9 of the 17 from the Modular Survey • 5 are in the Final Modular Survey

  18. In summary…… • Consumer perception of care key measurement domain • Its measurement must meet certain criteria in order to be worth the effort • The Modular Survey is the only current instrument measuring consumer perception of care that is: • SUD Rx – specific • Product of both consensus and empirical analysis • Short and actionable

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