title: Routine outcome monitoring and process quality in mental health care: a descriptive study in daily practice.
abstract: OBJECTIVE
  Routine outcome monitoring (ROM) is used to improve quality of health care by improving the process of care. ROM was introduced nationwide in mental health care in the Netherlands with the primary goal of enhancing the quality of treatment. This study aims to establish the impact of ROM on the process quality of treatment in the daily practice of secondary mental health care in the Netherlands.
  
  
  METHODS
  Two cohorts from the same treatment programme were identified, before and after implementation of ROM. Data on patient characteristics, presence of baseline ROM measurement and indicators of the quality of the treatment process were retrieved from the electronic health care information system. Patient data were collected until 6 months after enrolment in the treatment programme. The magnitude of the effect of ROM on the quality of the treatment process was established.
  
  
  RESULTS
  The pre-ROM cohort comprised 271 patients and 231 patients constituted the post-ROM cohort. In the ROM cohort, both indicators for process quality 'presence of treatment plan' and 'presence of cancellations' were significantly higher; the odd ratios were 3,37 [confidence interval (CI) 2.32-4.89] and 1,63 (CI 1.14-2.33), respectively.
  
  
  CONCLUSIONS
  Indicators on process quality are important for understanding and establishing the impact of ROM in daily practice of secondary mental health care. Implementing ROM moderately increased the presence of a treatment plan. While this suggests improved treatment agreement, it did not result in better compliance of patients with individual treatment activities, as presence of cancellations was significantly higher after introduction of ROM.
authors.affiliation: Psychiatric Centre, GGz Centraal, Hilversum, The Netherlands.
authors.forename: Wim
authors.identifier: http://orcid.org/0000-0002-5414-9332
authors.initials: W
authors.lastname: Siebum
authors.affiliation: Psychiatric Centre, GGz Centraal, Amersfoort, The Netherlands.
authors.forename: Ysbrand J
authors.initials: YJ
authors.lastname: Pijl
authors.affiliation: Academic Medical Centre, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands.
authors.forename: G Sander
authors.initials: GS
authors.lastname: de Wolf
mesh_terms: D000328:Adult; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care
keywords: evaluation; health care; health services research; process quality; routine outcome monitoring