Magazine article Behavioral Healthcare Executive

Measuring the Seven 'Rs': CRC's Rating Audit Instrument Allows the Team to Review, Report, Rate, Respond, React, Reassess, and Resolve

Magazine article Behavioral Healthcare Executive

Measuring the Seven 'Rs': CRC's Rating Audit Instrument Allows the Team to Review, Report, Rate, Respond, React, Reassess, and Resolve

Article excerpt

CRC Health Group, headquartered in Cupertino, California, has 145 behavioral healthcare facilities in 29 states, with more than 5,000 employees serving more than 29,000 people every day. CRC's Quality Management and Clinical Services (QM/CS) Team directly assists each treatment facility within CRC's Recovery Division. The QM/CS Team develops, implements, monitors, and trends quality improvement activities for 62 comprehensive treatment clinics (CTCs) in 18 states, and team members realized in 2003 that they needed a standardized evaluation tool to meet their goals.

[ILLUSTRATION OMITTED]

Thus, the QM/CS team developed the Quality Management Rating Audit Instrument (RAI). which allows the team to accomplish seven "R" factors: review, report, rate, respond, react, reassess, and resolve. These R factors allow for an ongoing, complete, comprehensive, review of each facility. The RAI has ten district performance measurement categories:

* Quantitative Documentation and Treatment Continuity/Randomly Selected Patient Records

* Quality of Treatment and Documentation/Randomly Selected Patient Records

* Quality of Treatment and Documentation/Special Patient Records

* Administrative Oversight

* Human Resources/Staffing

* Customer Satisfaction/Services

* Marketing/Public Relation

* Regulatory Compliance

* Staff Development/Training

* Special Services

CTCs receive two on-site audits per year, during which the QM/CS Team auditor collects data using the following sources:

* Inspection/review of patient files (active and inactive)

* Inspection/review of human resources and personnel files

* Inspection/review of administrative files

* Walk-through(s) of the program facility

* Interviews with staff members

* Review of other survey/audit reports, outcomes, and plans of correction

In addition, the auditor collects narrative information for each RAI category, identifying areas of strength or those needing improvement as well as offering other comments (e.g., training needs). The reviewer scores each performance measurement area on a 1 to 10 Likert scale:

Table Overall RAI mean scores for CTCs

Performance Measurement  December   June        Percentage
Indicator                2006 All   2007        Change
                         Clinic     All
                         Mean *     Clinic
                                    Mean **

Quantitative                  6.7     7.1       +0.4%
Documentation and
Treatment
Continuity/Randomly
Selected Patient
Records

Quality of Treatment          7.1     7.4       +0.3%
and
Documentation/Randomly
Selected Patient
Records

Quality of Treatment         6.8     7.1        +0.3%
and
Documentation/Special ]
Patient Records

Administrative                7.8     8.0       +0.2%
Oversight

Human                         7.5     7.5        0.0%
Resources/Staffing

Customer                      7.7     7.8       +0.1%
Satisfaction/Services

Marketing/Public              7.8     8.2       +0.4%
Relations

Regulatory Compliance         8.3     8.3        0.0%

Staff                         7.3     7.7       +0.4%
Development/Training

Special Services              6.6     7.6       +1.0%

* Representative of mean scores for June to December 2006 for 55
CTC programs; ** representative of mean scores for January
to June 2007 for 58 CTC programs.

* 1 to 4-nonconformance. A plan of action is required within 7 days to initiate movement toward conformance.

* 5 to 7-moderate conformance. …

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