title: Bridging the science-to-service gap in schizophrenia care in the Netherlands: the Schizophrenia Quality Improvement Collaborative.
abstract: OBJECTIVE
  Many patients with schizophrenia are not treated in line with evidence-based guidelines. This study examines the large-scale implementation of the National Multidisciplinary Guideline for schizophrenia in the Netherlands.
  
  
  METHODS
  /st> Observational, prospective study, with repeated measurement.
  
  
  METHODS
  Thirty mental healthcare teams in different regions of the Netherlands.
  
  
  METHODS
  Three hundred and fifty-nine clinicians with different professional backgrounds and 1489 patients suffering from schizophrenia.
  
  
  METHODS
  Six evidence-based interventions for schizophrenia were implemented, in the context of a quality improvement collaborative: assertive community treatment (ACT) or its adapted version functional assertive community treatment (FACT), cognitive behavioural therapy, psycho-education, family interventions, individual placement support and pharmacotherapy.
  
  
  METHODS
  Professional performance, social functioning and relapse rates.
  
  
  RESULTS
  Improved professional performance, in line with guidelines. Availability of (F)ACT improved from 23 to 60%. Individual Placement Support improved from 20 to 53%. Complete care plans were composed for 38% of the patients and routine outcome monitoring was introduced in most teams. Social functioning improved slightly (HoNOS mean: from 6.2 to 5.6). Relapse rates did not improve during the course of the study.
  
  
  CONCLUSIONS
  An intensive implementation programme can result in an improved delivery of evidence-based care, increased continuity of care and slightly improved outcomes for individuals with schizophrenia. More rigorous research designs have to confirm these findings.
authors.affiliation: Trimbos-instituut, PO Box 725, 3500 AS Utrecht, The Netherlands. dduin@trimbos.nl.
authors.forename: Danielle
authors.initials: D
authors.lastname: Van Duin
authors.forename: Gerdien
authors.initials: G
authors.lastname: Franx
authors.forename: Bob
authors.initials: B
authors.lastname: Van Wijngaarden
authors.forename: Mark
authors.initials: M
authors.lastname: Van Der Gaag
authors.forename: Jaap
authors.initials: J
authors.lastname: Van Weeghel
authors.forename: Cees
authors.initials: C
authors.lastname: Slooff
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D016730:Program Development; D011446:Prospective Studies; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D012559:Schizophrenia / Q000628:therapy*; D055502:Secondary Prevention; D012917:Social Adjustment; D016896:Treatment Outcome; D055815:Young Adult
keywords: disease categories; measurement of quality; mental health disorders; quality improvement; quality indicators; quality management