title: A randomized controlled study of a web-based performance improvement system for substance abuse treatment providers.
abstract: We report here the results of a randomized, controlled trial evaluating the efficacy of a semiautomated performance improvement system ("patient feedback") that enables real-time monitoring of patient outcomes in outpatient substance abuse treatment clinics. The study involved 118 clinicians working at 20 community-based outpatient substance abuse treatment clinics in the northeast United States. Ten clinics received 12 weeks of the patient feedback performance improvement intervention, and 10 clinics received no intervention during the 12 weeks. More than 1,500 patients provided anonymous ratings of therapeutic alliance, treatment satisfaction, and drug/alcohol use. There was no evidence of an intervention effect on the primary drug and alcohol use scales. There was also no evidence of an intervention effect on secondary measures of therapeutic alliance. Clinician-rated measures of organizational functioning and job satisfaction also showed no intervention effect. Possible insights from these findings and alternative methods of utilizing feedback reports to enhance clinical outcomes are proposed.
authors.affiliation: University of Pennsylvania, Philadelphia, PA 19104, USA. crits@mail.med.upenn.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Crits-Christoph
authors.forename: Sarah
authors.initials: S
authors.lastname: Ring-Kurtz
authors.forename: Bridget
authors.initials: B
authors.lastname: McClure
authors.forename: Christina
authors.initials: C
authors.lastname: Temes
authors.forename: Agatha
authors.initials: A
authors.lastname: Kulaga
authors.forename: Robert
authors.initials: R
authors.lastname: Gallop
authors.forename: Robert
authors.initials: R
authors.lastname: Forman
authors.forename: John
authors.initials: J
authors.lastname: Rotrosen
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D003156:Community Mental Health Services; D003194:Computer-Assisted Instruction; D003479:Curriculum; D004650:Employee Performance Appraisal; D005246:Feedback; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007318:Inservice Training; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011615:Psychotherapy, Group; D019984:Quality Indicators, Health Care; D012047:Rehabilitation Centers; D019966:Substance-Related Disorders / Q000534:rehabilitation*