Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data

Introduction

This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QlPs) that have been promulgated by health care organizations. government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient data gathered by such QIPs. Although developed for psychologists, these criteria may be useful across health service areas and professions.

The health care marketplace has witnessed an increased interest on the part of third-party payers, both public/governmental and private, in the development of pay-for-performance and other "quality improvement" programs for the purpose of improving the health care outcomes of patients.1 These programs vary in design, program implementation, and quality measures. Psychologists who are health care providers will soon find themselves, if they have not already, confronted with having to make decisions about participating in one or more of these programs.

Recognizing that psychologists have considerable expertise in program development and evaluation, the American Psychological Association (APA) can make a useful contribution to the evaluation of such programs. To date, the available QIPs have been of varying quality and relevance to the practice of psychology. Psychologists are supportive of programs that genuinely improve the benefits of health care services to the public and improve the quality of services provided. However, well-designed QIPs achieve these goals while also protecting the rights of patients (e.g., confidentiality) and respecting the professional responsibilities and clinical judgment of psychologists.

1To be consistent with discussions of quality improvement in other areas of health care, the term patient is used here to refer to the recipient of psychological services. However, the APA Performance Improvement Advisory Group recognizes that in many situations there are important and valid reasons for using such term as client, consumer, or person in place of patient to describe the recipient of services.