title: Providers' perceptions of the implementation of a performance measurement system for substance abuse treatment: A process evaluation of the Service Quality Measures initiative.
abstract: BACKGROUND
  In South Africa, concerns exist about the quality of substance abuse treatment. We developed a performance measurement system, known as the Service Quality Measures (SQM) initiative, to monitor the quality of treatment and assess efforts to improve quality of care. In 2014, the SQM system was implemented at six treatment sites to evaluate how implementation protocols could be improved in preparation for wider roll-out.
  
  
  OBJECTIVE
  To describe providers' perceptions of the feasibility and acceptability of implementing the SQM system, including barriers to and facilitators of implementation.
  
  
  METHODS
  We conducted 15 in-depth interviews (IDIs) with treatment providers from six treatment sites (two sites in KwaZulu-Natal and four in the Western Cape). Providers were asked about their experiences in implementing the system, the perceived feasibility of the system, and barriers to implementation. All IDIs were audio-recorded and transcribed verbatim. A framework approach was used to analyse the data.
  
  
  RESULTS
  Providers reported that the SQM system was feasible to implement and acceptable to patients and providers. Issues identified through the IDIs included a perceived lack of clarity about sequencing of key elements in the implementation of the SQM system, questions on integration of the system into clinical care pathways, difficulties in tracking patients through the system, and concerns about maximising patient participation in the process.
  
  
  CONCLUSIONS
  Findings suggest that the SQM system is feasible to implement and acceptable to providers, but that some refinements to the implementation protocols are needed to maximise patient participation and the likelihood of sustained implementation.
authors.affiliation: Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa. bmyers@mrc.ac.za.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Myers
authors.forename: Petal Petersen
authors.initials: PP
authors.lastname: Williams
authors.forename: Kim
authors.initials: K
authors.lastname: Johnson
authors.forename: Rajen
authors.initials: R
authors.lastname: Govender
authors.forename: Ron
authors.initials: R
authors.lastname: Manderscheid
authors.forename: J Randy
authors.initials: JR
authors.lastname: Koch