A clinical leadership lens on implementing progress feedback in three countries: development of a multidimensional qualitative coding scheme
A clinical leadership lens on implementing progress feedback in three countries: development of a multidimensional qualitative coding scheme
Background: progress feedback, also known as measurement-based care (MBC), is the routine collection of patient-reported measures to monitor treatment progress and inform clinical decision-making. Although a key ingredient to improving mental health care, sustained use of progress feedback is poor. Integration into everyday workflow is challenging, impacted by a complex interrelated set of factors across patient, clinician, organizational, and health system levels. This study describes the development of a qualitative coding scheme for progress feedback implementation that accounts for the dynamic nature of barriers and facilitators across multiple levels of use in mental health settings. Such a coding scheme may help promote a common language for researchers and implementers to better identify barriers that need to be addressed, as well as facilitators that could be supported in different settings and contexts.
Methods: clinical staff, managers, and leaders from two Dutch, three Norwegian, and four mental health organizations in the USA participated in semi-structured interviews on how intra- and extra-organizational characteristics interact to influence the use of progress feedback in clinical practice, supervision, and program improvement. Interviews were conducted in the local language, then translated to English prior to qualitative coding.
Results: a team-based consensus coding approach was used to refine an a priori expert-informed and literature-based qualitative scheme to incorporate new understandings and constructs as they emerged. First, this hermeneutic approach resulted in a multi-level coding scheme with nine superordinate categories and 30 subcategories. Second-order axial coding established contextually sensitive categories for barriers and facilitators.
Conclusions: the primary outcome is an empirically derived multi-level qualitative coding scheme that can be used in progress feedback implementation research and development. It can be applied across contexts and settings, with expectations for ongoing refinement. Suggestions for future research and application in practice settings are provided. Supplementary materials include the coding scheme and a detailed playbook.
Implementation, Measurement-based care, Organizational, Progress Feedback, Qualitative
Douglas, Susan
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Bovendeerd, Bram
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van Sonsbeek, Maartje
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Manns, Mya
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Milling, Xavier Patrick
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Tyler, Ke'Sean
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Bala, Nisha
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Satterthwaite, Tim
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Hovland, Runar Tengel
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Amble, Ingunn
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Atzil-Slonim, Dana
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Barkham, Michael
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de Jong, Kim
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Kendrick, Tony
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Nordberg, Samuel S.
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Lutz, Wolfgang
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Rubel, Julian A.
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Skjulsvik, Tommy
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Moltu, Christian
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Douglas, Susan
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Bovendeerd, Bram
135c492b-3b68-4d05-bf7d-b13224feba27
van Sonsbeek, Maartje
b48ba398-6a8f-4ae1-8f6c-47f740be7b9e
Manns, Mya
26215898-b1ca-476f-a77b-0274569b6976
Milling, Xavier Patrick
34a2a611-2e4b-43d8-b261-08e6b35eb608
Tyler, Ke'Sean
0089bb66-619f-493f-b82a-a706ee09f1ea
Bala, Nisha
34f102ec-4ac5-4e78-afb1-8458a652adca
Satterthwaite, Tim
19ec916e-e85e-497b-a14d-62022a0bc9c9
Hovland, Runar Tengel
62a07822-36c7-4554-87b4-03d77aca4645
Amble, Ingunn
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Atzil-Slonim, Dana
4a1328ee-4e07-448c-a8e1-7fdbcfcaacc4
Barkham, Michael
e719fee6-e016-4a09-a9e9-9a2dc6fc390a
de Jong, Kim
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Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Nordberg, Samuel S.
51023d17-f2a4-47b9-ae72-4cfe7a1bbee0
Lutz, Wolfgang
da0e4bfd-3b63-4ee2-896a-294a82e56859
Rubel, Julian A.
685d2b3b-17b3-46f1-ac26-91c6be830229
Skjulsvik, Tommy
e95fd774-2259-4293-855d-5a843154706b
Moltu, Christian
305e98dc-031d-4469-a638-15ea8a9bfc73
Douglas, Susan, Bovendeerd, Bram, van Sonsbeek, Maartje, Manns, Mya, Milling, Xavier Patrick, Tyler, Ke'Sean, Bala, Nisha, Satterthwaite, Tim, Hovland, Runar Tengel, Amble, Ingunn, Atzil-Slonim, Dana, Barkham, Michael, de Jong, Kim, Kendrick, Tony, Nordberg, Samuel S., Lutz, Wolfgang, Rubel, Julian A., Skjulsvik, Tommy and Moltu, Christian
(2023)
A clinical leadership lens on implementing progress feedback in three countries: development of a multidimensional qualitative coding scheme.
Administration and Policy in Mental Health and Mental Health Services Research.
(doi:10.1007/s10488-023-01314-6).
Abstract
Background: progress feedback, also known as measurement-based care (MBC), is the routine collection of patient-reported measures to monitor treatment progress and inform clinical decision-making. Although a key ingredient to improving mental health care, sustained use of progress feedback is poor. Integration into everyday workflow is challenging, impacted by a complex interrelated set of factors across patient, clinician, organizational, and health system levels. This study describes the development of a qualitative coding scheme for progress feedback implementation that accounts for the dynamic nature of barriers and facilitators across multiple levels of use in mental health settings. Such a coding scheme may help promote a common language for researchers and implementers to better identify barriers that need to be addressed, as well as facilitators that could be supported in different settings and contexts.
Methods: clinical staff, managers, and leaders from two Dutch, three Norwegian, and four mental health organizations in the USA participated in semi-structured interviews on how intra- and extra-organizational characteristics interact to influence the use of progress feedback in clinical practice, supervision, and program improvement. Interviews were conducted in the local language, then translated to English prior to qualitative coding.
Results: a team-based consensus coding approach was used to refine an a priori expert-informed and literature-based qualitative scheme to incorporate new understandings and constructs as they emerged. First, this hermeneutic approach resulted in a multi-level coding scheme with nine superordinate categories and 30 subcategories. Second-order axial coding established contextually sensitive categories for barriers and facilitators.
Conclusions: the primary outcome is an empirically derived multi-level qualitative coding scheme that can be used in progress feedback implementation research and development. It can be applied across contexts and settings, with expectations for ongoing refinement. Suggestions for future research and application in practice settings are provided. Supplementary materials include the coding scheme and a detailed playbook.
Text
Qual1 APMH revision 18jun2023 no identifiers
- Accepted Manuscript
Available under License Other.
More information
Accepted/In Press date: 12 October 2023
e-pub ahead of print date: 2 November 2023
Additional Information:
Funding Information:
This study was initially conceptualized from discussions between feedback researchers during the International Network for Psychotherapy Innovations and Research into Effectiveness (INSPIRE) meetings held at Leiden University in 2017 and 2018. The authors would like to thank Julian Edbrooke Childs, Miranda Wolpert, and Günter Schipek who participated in these discussions. Our appreciation goes to Peabody College at Vanderbilt University for partial support of the project with a Peabody small grant award, and to the Vanderbilt University students who helped along the way, including Ariane Willson and Maria Sheridon. Førde Hospital Trust supported Runar Hovland’s participation in the project with a short-term grant. The Dimence Group supported the Netherland’s authors with funding for transcription services.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords:
Implementation, Measurement-based care, Organizational, Progress Feedback, Qualitative
Identifiers
Local EPrints ID: 485919
URI: http://eprints.soton.ac.uk/id/eprint/485919
ISSN: 0894-587X
PURE UUID: 5950c2fb-367a-432d-9336-4bdc8269455e
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Date deposited: 04 Jan 2024 04:22
Last modified: 02 Nov 2024 05:01
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Contributors
Author:
Susan Douglas
Author:
Bram Bovendeerd
Author:
Maartje van Sonsbeek
Author:
Mya Manns
Author:
Xavier Patrick Milling
Author:
Ke'Sean Tyler
Author:
Nisha Bala
Author:
Tim Satterthwaite
Author:
Runar Tengel Hovland
Author:
Ingunn Amble
Author:
Dana Atzil-Slonim
Author:
Michael Barkham
Author:
Kim de Jong
Author:
Samuel S. Nordberg
Author:
Wolfgang Lutz
Author:
Julian A. Rubel
Author:
Tommy Skjulsvik
Author:
Christian Moltu
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