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RTF Quality Report Released
October 26, 2005

External Quality Review Findings
The Department of Public Welfare has released the final report addressing residential treatment facility (RTF) quality indicators. Conducted by IPRO, the project was an external review of county-managed care organization contracted RTF services related to the HealthChoices program. The report is a re-measurement of three key indicators originally studied in 2001/02. The quality indicators used for the study were:

  • Family involvement in residential treatment facility care measured by on-site meetings within seven days of admission (79.6 percent state wide compliance rate),
  • Coordination of outpatient follow-up measured by the rate of client documentation sent to ambulatory mental health providers prior to discharge (16.6 percent state wide compliance rate), and
  • Medication rationale documentation measured by the presences of clinical rational for medication documented in the psychiatric discharge summary or final evaluation (64.6 percent state wide compliance rate).

The study reviewed 951 client medical records with a finding of statistically significant improvement from the prior study, but with performance on all three quality indicators still falling short of the department’s performance goals. Included in the full report is the statistical performance of all RTFs that participated in the review.

Key Recommendations
While the study showed demonstrable improvement in the area of family involvement, it identifies clear opportunities for improvement in the area of coordination of care with outpatient providers. The timely provisions of treatment documentation and medication rationale continue to be areas for improved process and practice. The report offers several recommendations for process improvement, including:

  • establishment of standardized discharge protocols,
  • check lists for RTF discharge and post-discharge tasks,
  • development of a standard format for RTF discharge summaries,
  • discharge summary formats that capture medication information and mediation rationale, and
  • development of RTF clinical practice guidelines that reinforce family involvement.

Association members who would like a complete copy of the 86-page report should contact Connell O’Brien.

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