Total quality management in behavioral health care.

The literature on total quality management or continuous quality improvement in the behavioral health care field is just beginning to emerge. Although most of the evidence on its effectiveness remains anecdotal, it seems clear that it can work in behavioral health care organizations with strong leadership support and a long-term commitment.

Measuring the performance of behavioral healthcare organizations: a proposed model.

Practitioners in the field of behavioral healthcare are under increasing pressure to demonstrate the effective and efficient delivery of services. While there are a variety of models that provide important elements of a framework for defining and measuring organizational performance, few appear to integrate the unique perspectives of all the organization's key constituent or customer groups.

Application of TQM to mental health: lessons from ten mental health centers.

BACKGROUND: The principles and techniques of total quality management (TQM) have only recently been applied to the field of mental health. This article reviews issues and offers some preliminary observations, based on the author's consultation and training work with ten state-operated mental health organizations in Missouri (Jul 1, 1994-Jun 30, 1995). CULTURAL DIMENSION: Since many mental health organizations have operated in the public sector as part of large, hierarchical state agencies, the legacy of bureaucratic structures and a command and control leadership style may pose additional challenges. TECHNICAL DIMENSION: Two types of training have proven helpful in the Missouri project: general overview or awareness training for all staff and specialized training for team leaders and facilitators. STRATEGIC DIMENSION: To be successful with TQM, mental health organizations should clearly delineate their governing ideas, continuously reinforce them with all staff, and use the ideas as a measuring stick for progress. Some of the organizations in the Missouri project link their governing ideas and strategic planning efforts with critical success factors and the measurement methodology to track them. STRUCTURAL DIMENSION: This dimension, which may include a quality council, a quality department, and quality improvement (QI) teams, also extends to the way in which facilities are organized and function. The structure evolving from a team-oriented, time-limited, data-based, and problem-solving approach can facilitate the functioning of the entire organization. CONCLUSIONS: The philosophy and techniques of TQM are as applicable to mental health as to health care in general--the question is one more of motivation than of fit.

Application of total quality management to mental health: a benchmark case study.

The search for models or "benchmarks" that reflect the successful application of total quality management (TQM) to the mental health field is one that goes largely unrewarded. This article describes a case study of one comprehensive mental health center that has made a serious commitment to the philosophy and principles of TQM and that is reaping significant benefits from that effort.

Mental health leadership training: a survey of state directors.

There is periodic support in the mental health literature for increased training opportunities in the area of management and leadership. The purpose of this study was to verify the need for such training as perceived by state directors of mental health and mental retardation/developmental disabilities programs and to explore related issues. The results confirmed a perception of need and provided insights into ways that such training might be successfully provided to states.

Statistical process control and direct care staff performance.

A state-operated residential facility has for the past five years been using performance feedback as the primary method for improving direct care staff interactions with clients. The major problem with this approach is determining when staff performance is significantly above or below average. Statistical process control charts are being used to determine whether variations in staff performance are the result of common or special causes. Analysis of staff performance for one year suggests that variation in staff performance may be due to special causes, such as the characteristics of the clients served and the type of service that is provided to these clients. Services were adapted to the characteristics of these clients, which improved staff performance and reduced variation.