4055.0: Tuesday, October 23, 2001 - 8:45 AM

Abstract #30068

Challenges of implementing studies linking quality of care to patient outcomes

Monique A. Wyatt and Barbara Dickey, PhD. Department of Psychiatry, Harvard Medical School, The Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139, 617-503-2399, monique_wyatt@hms.harvard.edu

This presentation will address some of the challenges we encountered in our prospective study of Medicaid patients with schizophrenia in the state of Massachusetts. We will first discuss our process for enrolling patients in our study at a time of psychiatric crisis and identify how this process affected study implementation. Once we enrolled clients and were given consent to review their medical records, we also encountered barriers to data collection. For example, despite obtaining a number of local, state and federal certificates to ensure the confidentiality of our patient data, it was necessary for us to seek additional approval from 26 institutional review boards (IRBs) in order to obtain access to patient records. This process delayed access to some records for nearly one year. Lastly, we will discuss how the abstraction of outpatient medical records revealed that the quality of the records was substandard. Unlike inpatient records, outpatient records are not standardized or closely monitored. This is problematic when considering that most psychiatric care occurs in an outpatient setting. We will report on our findings of outpatient medical record quality based on various criteria related to record content and ease of locating information within the record.

Learning Objectives: Participants will be able to: 1)Recognize some of the challenges facing researchers who link patient outcomes to the quality of patient care; 2)Identify how medical record quality can be improved.

Keywords: Mental Illness, Quality of Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA