Spurred by questions from patients, their families and payors, Rose Hill Center set out three years ago to better document the outcomes of its residential psychiatric treatment programs.
“People have always benefited from the treatment we do at Rose Hill; what we wanted to do was amplify that,” by demonstrating that the center’s approach is impactful, said President and CEO Ben Robinson.
With support from local foundations, in 2015 it invested $100,000 in a new, software-based system, the Daily Living Assessment 20, establishing baseline clinical statistics to evaluate how well its residents are doing and the effectiveness of its programs and procedures. The center has self-funded additional costs of about $50,000 each year to renew the software license and hire contract staff to help with assessments.
Rose Hill Center is now collecting information through interviews on residents’ daily living activities, including their personal care and hygiene, interactions with others, nutrition, time management and problem solving. Those daily living scores are measuring something intangible: their overall wellness.
“The main reason we collect the information is to see the outcomes for the people we serve,” Robinson said, and to make adjustments where needed.
The center, which operates on a $6 million budget, has about 70 people in its core residential treatment program.
It didn’t see as much progress as it would have liked in the daily living scores after launching the program, Robinson said. So, last year, based on the data and feedback from residents and families, Rose Hill added verbal therapy on a one-to-one and group basis, focused on particular illnesses, such as personality disorders.
During 2017, residents of Rose Hill’s core residential program, who stayed about eight months, saw a 31 percent improvement, on average, in daily living activity scores, from admission to discharge.
Those in its co-occurring program, with both a mental illness and a substance abuse addiction, saw an average improvement of 80 percent in daily living skills. And the dozen or so people who moved into semi-independent living on Rose Hill’s campus saw a 114-percent average improvement.
Last year, Rose Hill added a second assessment to measure outcomes, following a mandate from the Joint Commission, a national, nonprofit health care accrediting agency.
And it launched an additional program to track the success of its residents post-treatment for two years, with funding from the Community Foundation for Southeast Michigan. It’s checking in with residents after they have been discharged to assess whether they are in a stable living environment, have been rehospitalized or incarcerated, as well as activities in their daily life and their relationships with family and friends.
“That’s really important at the end of the day: how well people do after they leave us,” Robinson said.
Beyond its clinical measurement, Rose Hill also began measuring staff turnover and shortages of fully trained staff, an issue facing the entire human service industry.
Frequent staff turnover has a negative impact on quality, Robinson said. Not only is it costly, but it negatively impacts continuity of relationships between staff and residents.
“Having high-quality staff with longer tenure … is definitely helping us with outcomes,” he said.
To help address turnover, Rose Hill hired a human resource manager focused on recruitment, initial onboarding and training and employee morale, something that’s helping with staff retention, Robinson said.