Outcome Measures Standard

Achieving Joint Commission Accreditation

What are the requirements and changes?
The revisions to Standard CTS.03.01.09 consist of the following:

  • Revised element of performance (EP) 1 that requires organizations to use a standardized tool or instrument to monitor an individual’s progress 

  • New EP 2 that requires organizations to analyze the data generated by this activity and use the results to inform the individual’s goals and objectives as needed 

  • Revised EP 2, renumbered as EP 3, that requires organizations to use their data to evaluate outcomes of care, treatment, or services provided to the population(s) they serve

Treatment planning with the BAM
BAM can help by:
Determining the patient's strengths
Indicating the presence of a problem
Providing evidence of goal achievement by measuring progress on objectives.
Targeting and measuring the effectiveness of interventions for specific deficiencies in the patient's lifestyle.

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“Enhanced precision and consistency in disease assessment, tracking, and treatment to achieve optimal outcomes”

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Results-Driven Sample
In the past 30 days (or 7 days if Follow-up), how many days have you felt depressed, anxious, angry or very upset throughout most of the day?

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In the past 30 days (or 7 days if Follow-up), how many days did you drink ANY alcohol?

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The Measurement-Based Care Approach
All clients in treatment for SUD receive a baseline BAM upon admission to the program.

The baseline data and feedback (MET) session inform treatment planning.

Follow-up BAMs are administered repeatedly throughout the client’s course of treatment, typically every 30 days, just prior to treatment plan reviews, and at transition between levels of care.

The follow-up data and feedback sessions inform adaptive treatment efforts. Follow-up BAMs also may be administered as a mechanism of outreach, via MET, to out-of-treatment clients.​

Treatment Planning and the BAM: Interventions Based on Items
Specific items to attend to, and suggested referrals, include:

  • #1 (health), refer to primary care
  • #3 (mood), proceed to further assessment, i.e. suicide risk, and confer with MH Treatment Coordinator
  • #5,6,7 (heavy alcohol use, any drug use, specific drug use), any reported use warrants discussion with client to consider adjusting treatment (e.g., higher level of care or changing modality)
  • #8 (craving), consider medicinal adjuncts, i.e. naltrexone, acamprosate.
  • #14 (adequate income), consider CWT, HUD-VASH, vocational counseling.
  • #16 (social support), consider adding network support
  • #17 (satisfaction with progress), warrants discussion of modifications or supplements to treatment

Note: Examining scores from individual items as described above is the most clinically relevant use of this measure. Composite scoring is supplementary and very preliminary. It is based on clinical judgment rather than empirical data.

Measurement-Based Care...
“Enhanced precision and consistency in disease assessment, tracking, and treatment to achieve optimal outcomes”

Brief Addiction Monitor.
The origin of "BAM."
The Brief Addiction Monitor (BAM) was originally prompted by need to assess patient “outcomes” in the VA

An efficient system was also needed to monitor patient progress and provide guidance on modifications to treatment when necessary (the MBC part)

The emphasis is on measuring clinically useful factors:

Substance use – Other indicators of relapse risk – Recovery-oriented behaviors

 

 

Included with the Kipu EMR
Joint Commission Accredited
BRIEF ADDICTION MONITOR

BAM

Measurement-Based Care...

“Enhanced precision and consistency in disease assessment, tracking, and treatment to achieve optimal outcomes”

Brief Addiction Monitor.
The origin of "BAM."
The Brief Addiction Monitor (BAM) was originally prompted by need to assess patient “outcomes” in the VA

An efficient system was also needed to monitor patient progress and provide guidance on modifications to treatment when necessary (the MBC part)

The emphasis is on measuring clinically useful factors:

Substance use – Other indicators of relapse risk – Recovery-oriented behaviors

What exactly is BAM?

A 17-item measure of addiction problem severity that is designed to support measurement-based treatment in SUD specialty care settings.

May be administered inside KipuEMR electronically via tablet or smartphone as a clinical interview (in-person or telephonically) or via patient self-report; and, it typically takes a few minutes to complete.

Retrospectively examines the patient's behavior in the past 30-days, but has been adapted for repeated administrations as frequently as every 7 days (BAM for IOP).

Includes items that assess Risk factors for substance use, Protective factors that support sobriety, and drug and alcohol Use.

Produces composite scores for Risk and Protection as well as a Use score. A patient's clinical status may be assessed by examining individual BAM items and/or composite scores.

BAM features

It's brief (just 17 items)

It's Multi-dimensional, with no single summary score validated so far

Items selected from valid/reliable measures Initial item selection based on research on predictors of relapse and outcome

Data readily integrated into treatment planning

Categorical or continuous response options to items