Pine Rest has used multiple standardized outcome measures for years in the outpatient clinic network. These screening tools are a best practice for determining severity of symptoms, treatment goals and treatment effectiveness with individual clients.
“Standardized outcome measures provide a common language to evaluate the success of treatment,” said Evonne Edwards, PhD, Clinical Director for Outpatient Services. “Like having temperature, blood pressure, pulse, etc., taken when seeing a primary care physician or visiting urgent care, we use standardized outcome measures to determine the level of our patient’s symptoms, then compare them to established levels in order to determine treatment, and compare them to the patient’s prior scores to see if our treatments are working.”
Since one or more of these surveys were administered at approximately 80 percent of outpatient sessions over many years, Pine Rest has compiled an impressive database of scores totaling over 857,000 measure administrations, including over 637,000 administrations of the Patient Health Questionnaire (PHQ-9), a validated measure for depression. It’s possible that this is the largest database of scores for mental health screeners ever compiled by a single behavioral healthcare organization.
Studying the PHQ-9 database, Dr. Edwards’ team has identified that patients’ average scores had significantly decreased by the fifth session with a therapist. Now clinicians know they can adjust treatment if they have not seen these expected results within this time frame, something they can do much earlier than in the past.
Dr. Edwards has already compiled a long list of potential questions to “ask” the database, questions that will help determine what patient characteristics lead to better or worse responses to treatment, what variability in treatment results in differences in treatment outcomes for different patients, and what leads some patients to continue in treatment and others to drop out prior to achieving improvements in symptoms.
“We are also starting to partner on research involving the database. Because of its size, researchers looking for specific populations, conditions and outcomes will be able to find that subset in our data. Another benefit to researchers is that our patients reflect real-world patients, with more variability in what treatments they are taking and what conditions they are struggling with than controlled studies that often focus on one protocol with restrictions that sometimes reflect reality for a very small percent of our patients.”
—Evonne Edwards, PhD, Clinical Director for Outpatient Services
This article first appeared in the Pine Rest 2018 Annual Report.