What is the system challenge?

In the mental health and addictions system, a client’s perception is widely seen as a key indicator of the quality of the care. Though many organizations gather feedback from clients using a variety of tools, there is no consistent way that this information is collected and reported. Since there is so much variation in the types of client feedback surveys, the information gathered cannot adequately be used to guide quality improvement efforts at the program/service and system levels.

Evidence:

Measuring client satisfaction in mental health and addiction treatment is recognized as an important indicator of the quality of care as it is a direct measure of whether a client received services that met their expectations and needs (McLellan & Hunkeler, 1998; McLellan et al., 2007).

As an approach to evaluation and performance monitoring, measuring client satisfaction ensures that service providers have explored their clients’ perception of the various aspects of quality of care received. Such information may be collected with other quality-related information, (e.g., indicators of program engagement, retention and treatment participation, and outcome) and integrated into a larger performance measurement system (Rush et al., 2012).

Several key studies demonstrate the connection between client perception of care or satisfaction surveys and changes to the way services were delivered, creating a link from client feedback to quality improvement.

Find more evidence

With support from CAMH and the Provincial System Support Program at the Centre for Addiction and Mental Health, the OPOC-MHA survey tool is being implemented within Local Health Integration Networks/MOHLTC-funded addiction, mental health and concurrent disorders services across Ontario. The OPOC-MHA survey meets the need for a standardized perception of care tool used for informing, monitoring and evaluating quality improvements.

The OPOC-MHA provides a consistent way to gather client feedback in both community and hospital settings. This brings the client voice forward as a source of evidence to support program, agency and system quality improvement efforts

Perception of care asks about the care experience in relation to what is expected as “standard practice.” The tool asks six questions specific to a client’s experience and covers the following areas:

Access/entry to services;
Services provided;
Participation/Rights;
Therapists, staff, support workers;
Environment;
Discharge, program completion, treatment; and
Overall experience including recovery/outcome and service quality.

Demographic information is also collected to help organize the information and identify potential inequities in treatment. A central provincial database and report web portal gives organizations access to OPOC-MHA results which can be filtered and analyzed in a customized manner. For example, organizations can select specific indicators they wish to track over time, examine data through a health equity lens, and then look at specific programs to support quality improvement efforts. They also have access to aggregated, comparable provincial data.

At the system level, Local Health Integration Networks (LHINs) can access the results of their providers to identify system level quality improvement opportunities.

Who is involved?

OPOC-MHA engages hundreds of service providers across all 14 LHIN areas. This includes addiction, mental health and concurrent disorder services, both community and hospital-based.

Next Steps

OPOC-MHA implementation continues across the province. The measure is also providing a foundation for collaborative quality improvement endeavors – check out the Continuous Quality Improvement Collaborative (Link to project page)

CAMH PSSP

The Ontario Perception of Care Tool for Mental Health and Addictions (OPOC-MHA)

What is the system challenge?

What are we doing about it?

Who is involved?

Next Steps

Resources

For more information, please contact:

Renee Behrooz

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