ABSTRACT

Mental health organizations that serve youth are under pressure to adopt measurement-based care (MBC), defined as the continuous collection of client-report data used to support clinical decision-making as part of standard care. However, few frameworks exist to help leadership ascertain how to select an MBC approach for a clinical setting. This paper seeks to define how an MBC approach can display clinical utility to provide such a framework. Broadly, we define clinical utility as evidence that an MBC approach assists stakeholders in fulfilling clinical goals related to care quality (i.e., improve client-clinician alliance and clinical outcomes) at the client (i.e., youth and caregiver), clinician, supervisor, and administrator levels. More specifically, our definition of clinical utility is divided into two categories relevant to the usability and usefulness of an MBC approach for a specific setting: (a) implementability (i.e., evidence indicating ease of use in a clinical setting) and (b) usefulness in aiding clinical activities (i.e., evidence indicating the potential to improve communication and make clinical activities related to care quality easier or more effective). These categories provide valuable information about how easy an MBC approach is to use and the potential benefits that the MBC data will confer. To detail how we arrived at this definition, we review prior definitions of clinical utility, discuss how previous definitions inform our definition of clinical utility for MBC, and provide examples of how the concept of clinical utility can be applied to MBC. We finish with a discussion of future research directions.

摘要

为青少年服务的心理健康组织面临着采用基于测量的护理 (MBC) 的压力，MBC 的定义是持续收集客户报告数据，用于支持临床决策，作为标准护理的一部分。然而，很少有框架可以帮助领导层确定如何为临床环境选择 MBC 方法。本文旨在定义 MBC 方法如何展示临床实用性以提供这样的框架。从广义上讲，我们将临床效用定义为证据表明 MBC 方法可以帮助利益相关者实现与客户（即青少年和护理人员）、临床医生、主管和患者的护理质量相关的临床目标（即改善客户-临床医生联盟和临床结果）。管理员级别。进一步来说，我们对临床实用性的定义分为与 MBC 方法在特定环境下的可用性和有用性相关的两类：(a) 可实施性（即，表明在临床环境中易于使用的证据）和 (b) 帮助临床的有用性活动（即表明有可能改善沟通并使与护理质量相关的临床活动更容易或更有效的证据）。这些类别提供了有关 MBC 方法的易用性以及 MBC 数据将带来的潜在好处的宝贵信息。为了详细说明我们如何得出这个定义，我们回顾了临床效用的先前定义，讨论了先前的定义如何影响我们对 MBC 临床效用的定义，并提供了如何将临床效用概念应用于 MBC 的示例。