2 April 2016

National Quality Registry for Psychiatric Care Monitoring (“The Quality Star”)

  • Registry Manager: Region Västra Götaland
  • Registry Centre - affiliation: Registry Centre VGR
  • Start year: 2000.
  • Classifications used: KVÅ, ICD10
  • This registry contains data on: Diagnoses, Interventions, Inpatient Care, Specialised Outpatient Care, PROM or other patient-reported health effects, Risk Factors, Follow-up Data 12 months or later after the case is registered in the registry

Description of registry

Interventions for patients with severe mental illness are provided by both municipal and specialised psychiatric care institutions. Care and support interventions, as well as interventions from others, must be coordinated.

Resource Group Assertive Community Treatment (RACT), also called integrated psychiatry, is a described method for coordinating the work between different actors (municipal, psychiatric and other). There have been considerable national efforts to develop these methods.

The Quality Star enables the monitoring of programme fidelity to the strategies of the RACT model. Fidelity is crucial for successful results.

Fidelity is monitored using the mini-CSI (Clinical Strategies for Implementation) checklist.

The following areas are assessed:

Assessments, goals and personal development plan

Efforts in the community

Resource group

Stress management for users and resource persons

Drug therapy

Social training

Psychological strategies

Crisis management

Physical health


Process and result indicators


The Quality Star shows changes over time. The following dimensions are measured annually:

  • As process indicators, fidelity to RACT with mini CS
  • As result indicators, according to the following table

Rated by patient

Rated by relative(s)

Rated by treatment provider

· Quality of life

· Subjectively perceived difficulties

· Satisfaction with care

· Situation of relative(s)

· Psycho-social functional level

· Symptom severity

· Description of somatic health status

· Description of social situation

By regularly monitoring fidelity to RACT, the registry can be used to develop health and social care. To some extent, data has been used to study treatment results at the group level. Data is useful for reviewing care plans with the patient. With multi-year care now common practice in many counties and institutions, the model has proven to be applicable in practice.

Population

Interventions for the psychiatric patients with severe disabilities are provided by both municipal and specialised psychiatric care institutions. Care and support efforts must be coordinated. Integrated psychiatry is a described method for coordinating efforts. There have been considerable national efforts to develop these methods. The Quality Star aims to both monitor the patients’ development and to monitor the institutions’ adherence to programmes for desirable working models. This will enable the monitoring of both results and effects on different levels and of outcome-influencing factors. Used in 2011 by about 100 psychiatric treatment facilities in Sweden. About 5000 registered patients. Used in both public and privately funded care.

Ages in the registry

Age 18 and up.

Total volume of registry

About 2500 individuals and about 8300 assessments.

Volume over the past operating year

About 3000 assessments, new registrations and follow-ups.

Coverage rate

Used in 2011 by about 100 psychiatric treatment facilities in Sweden. About 5000 registered patients. Used in both public and privately funded care.

References on validations

  • Ivarsson B, Lindström L, Malm U, Norlander T. The Self-Assessment Perceived Global Distress Scale-Reliability and Construct Validity - Perceived Global Distress Scale. Psychology. 2011. Vol.2, No.4, 283-290
  • Ivarsson B, Lindström L, Malm U, Norlander T. Consumer satisfaction, quality of life and distress with regard to social function and gender in severe mental illness. Open Journal of Psychiatry, 2011, 1, 88-97.
  • Ivarsson B. Tools for Outcome-informed management of mental illness - Psychometric properties of instruments of the Swedish clinical multicenter Quality Star cohort. Doctoral Dissertation. Karlstad University Studies 2011:34.
  • Nordén T, Ivarsson B, Malm U, Norlander T. Gender and Treatment Comparisons in a cohort of patients with psychiatric diagnoses. Social Behavior and Personality, 2011, 39(8), 1073-1086.

Note: Variable lists are updated on a regular basis and should therefore be seen as preliminary. For the latest version, please contact the registry.

Category: Psychiatry

Certification level: 3

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