Identifying perceived barriers to monitoring service quality among substance abuse treatment providers in South Africa

BMC Psychiatry

Charles DH Parry²  Rajen Govender¹  Ron Manderscheid⁵  J Randy Koch³  Rehana Kader⁶  Zainonisa Petersen⁴  Bronwyn Myers⁶ 

[1] Department of Sociology and Centre for Social Science Research, University of Cape Town, Cape Town, South Africa;Department of Psychiatry, Stellenbosch University, Cape Town, South Africa;Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA;Alcohol and Drug Abuse Research Unit, Medical Research Council, Cape Town, South Africa;National Association of County Behavioral Health and Developmental Disability Directors, Washington DC, USA;Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

关键词: South Africa;    Substance abuse treatment;    Service quality;    Service monitoring;    Performance measurement;   

Others  :  1123798
DOI  :  10.1186/1471-244X-14-31

 received in 2013-12-22, accepted in 2014-02-04,  发布年份 2014

【 摘 要 】

Background

A performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers’ to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development.

Methods

Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of substance abuse treatment services available in the country. The final sample comprised 21 representatives from 12 treatment facilities: eight treatment centres in the Western Cape and four in KwaZulu-Natal. Content analysis was used to extract core themes from these discussions.

Results

Participants identified barriers to the monitoring of service quality that included outdated modes of collecting data, personnel who were already burdened by paperwork, lack of time to collect data, and limited skills to analyse and interpret data. Participants recommended that developers engage with service providers in a participatory manner to ensure that service providers are invested in the proposed performance measurement system.

Conclusion

Findings show that substance abuse treatment providers are willing to adopt a performance measurement system and highlight several barriers that need to be addressed during system development in order to enhance the likelihood that this system will be successfully implemented.

【 授权许可】

   
2014 Myers et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Herman AA, Stein DJ, Seedat S, Heeringa SG, Moomal H, Williams DR: The South African Stress and Health (SASH) study: 12-month and lifetime prevalence of common mental disorders. South Afr Med J 2009, 99:339-344.
• [2]Pasche S, Myers B: Substance misuse trends in South Africa. Hum Psychopharmacol Clin Exp 2012, 27:338-341.
• [3]Degenhardt L, Whiteford HA, Ferrari AJ, Baxter AJ, Charlson FJ, Hall WD, et al.: Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010. Lancet 2013. early online publication. DOI: 10.1016/S0140-6736(13)61530-5
• [4]Wechsberg WM, Wu L, Zule WA, Parry CD, Browne FA, Luseno WK, Kline T, Gentry A: Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa. Subst Abuse Treat Prev Policy 2009, 4:11. DOI:10.1186/1747-597X-4-11 BioMed Central Full Text
• [5]Myers B, Louw J, Pasche S: Inequitable access to substance abuse treatment services in Cape Town, South Africa. SATPP 2010, 5:28. DOI:10.1186/1747-597X-5-28 BioMed Central Full Text
• [6]Myers B, Fakier N, Louw J: Stigma, treatment beliefs, and substance abuse treatment use in historically disadvantaged communities. Afr J Psychiat 2009, 12:218-222.
• [7]Parry CDH, Petersen P, Carney T, Needle R: Opportunities for enhancing and integrating HIV and drug services for drug using vulnerable populations in South Africa. Int J Drug Pol 2010, 21:289-295.
• [8]Dos Santos M, Rataemane ST, Fourie D, Trathen B: An approach to heroin use disorder intervention within the South African context: A content analysis study. Subst Abuse Treat Prev Policy 2010, 5:13. DOI:10.1186/1747-597X-5-13 BioMed Central Full Text
• [9]Mojtabai R, Crum RM: Perceived unmet need for alcohol and drug use treatments and future use of services: Results from a longitudinal study. Drug Alcohol Depen 2013, 127:59-64.
• [10]Institute of Medicine: Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington: National Academies Press; 2005.
• [11]Quanbeck A, Madden L, Edmundson E, Ford J, McConnell K, McCarty D, Gustafson D: A business case for quality improvement in addiction treatment: evidence from the NIATx collaborative. J Behav Health Ser R 2012, 39:91-100.
• [12]McCorry F, Garnick DW, Bartlett J, Cotter F, Chalk M: Developing performance measures for alcohol and other drug services in managed care plans. Washington Circle Group. Jt Comm J Qual Improv 2000, 26:633-643.
• [13]Garnick DW, Lee MT, Chalk M, Gastfriend D, Horgan CM, McCorry F, McLellan AT, Merrick EL: Establishing the feasibility of performance measures for alcohol and other drugs. J Subst Abuse Treat 2000, 23:375-385.
• [14]Harris AHS, Kivlahan D, Bowe T, Finney JW, Humphreys KH: Developing and validating process measures of health care quality: An application to alcohol use disorder treatment. Med Care 2009, 47:1244-1250.
• [15]Hoffman KA, Quanbeck A, Ford JH, Wrede F, Wright D, Lambert-Wacey D, Chvojka P, Hanchett A, McCarty D: Improving substance abuse data systems to measure “waiting time to treatment”: lessons learned from a quality improvement initiative. Health Inform. J 2011, 17:256-265.
• [16]Panas L, Caspi Y, Fournier E, McCarty D: Performance measures for outpatient substance abuse services: group versus individual counselling. J Subst Abuse Treat 2003, 25:271-278.
• [17]Resnick S, Griffiths M: Service quality in alcohol treatment: a qualitative study. Int J Ment Health Ad 2010, 8:453-470.
• [18]National Treatment Agency (NTA): A Long-Term Study of the Outcomes of Drug Users Leaving Treatment. London: NTA; 2010.
• [19]Rotondi NK, Rush B: Monitoring utilization of a large scale addiction treatment system: the drug and alcohol treatment information system (DATIS). Subst Abuse R Treat 2012, 6:73-84.
• [20]Nabitz U, van den Brink W, Walburg J: A quality framework for addiction treatment programs. Addict Behav 2005, 30:1254-1260.
• [21]Garnick DW, Horgan CM, Acevedo A, McCorry F, Weisner C: Performance measures for substance use disorders- what research is needed. Addict Sci Clin Pract 2012, 7:18. DOI:10.1186/1940-0640-7-18 BioMed Central Full Text
• [22]Durman J, Lucking T, Robertson L: Performance Management for Substance Abuse Treatment Providers. 2008. http://www.tie.samhsa.gov/Documents/pdf/PerfMgmt4SATx.pdf webcite. Available from: Centre for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA)
• [23]Myers B, Petersen Z, Kader R, Parry CDH: Moving beyond access. Towards a quality-oriented substance abuse treatment system in South Africa. South Afr Med J 2012, 102:667-668.
• [24]Forman R, Crits-Cristoph P, Kaynak O, Worley M, Hantula DA, Kulaga A, Rotrosen J, et al.: A feasibility study of a web-based performance improvement system for substance abuse treatment providers. J Subs Abuse Treat 2007, 33:363-371.
• [25]Herbeck DM, Gonzalez R, Rawson RA: Performance improvement in addiction treatment: efforts in California. J Psychoactive Drugs 2010, S6:261-268.
• [26]Koch JR, Breland AB, Shawver MN, Cropsey K: Assessing the utility of consumer surveys for improving the quality of behavioral healthcare services. J Behav Health Ser R 2011, 38:234-248.
• [27]Kilbourne AM, Keyser D, Pincus HA: Challenges and opportunities in measuring the quality of mental health care. Canadian J Psychiat 2010, 55:549-557.
• [28]Ogborne AC, Braun K, Rush BR: Developing an integrated information system for specialised addiction treatment agencies. J Behav Health Ser R 1998, 25:100-107.
• [29]Wisdom JP, Ford JK, Hayes RA, Edmundson E, Hoffman K, McCarty D: Addiction treatment agencies’ use of data: a qualitative assessment. J Behav Health Ser R 2006, 33:394-407.
• [30]Pinto RM, Yu G, Spector AY, Gorroochurn P, McCarty D: Substance abuse treatment providers’ involvement in research is associated with willingness to use findings in practice. J Subst Abuse Treat 2010, 39:188-194.
• [31]Connell J, Zurn P, Stilwell B, Awases M, Braichet JM: Sub-Saharan Africa: Beyond the health worker migration crisis? Soc Sci Med 2007, 64:1876-1891.
• [32]Statistics South Africa: Census 2011, Provinces at a Glance. 2012. Available at: http://www.statssa.gov.za/Census2011/Products/Provinces%20at%20a%20glance%2016%20Nov%202012%20corrected.pdf webcite
• [33]Temmingh H, Myers B: Clinical Treatment of Substance Use Disorders in South Africa. In Substance Use and Abuse in South Africa: Brain Behavioural and Other Perspectives. Edited by Ellis G, Stein D, Meintjies E, Thomas K. Cape Town: University of Cape Town Press; 2012:329-366.
• [34]Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurs Educ Today 2004, 24:105-112.
• [35]Dahlgren L, Emmelin M, Winkvist A: Open Code Qualitative Programme. Umeå, Sweden: Umeå, Sweden; 2004. http://www.umu.se/phmed/epidemi/forskning/opencode.html webcite (downloaded 2011)
• [36]Burnhams NH, Myers B, Fakier N, Parry CDH, Carelse J: Substance abuse surveillance among district social workers in South Africa. Drugs Educ Prev Pol 2010, 3:1-10.
• [37]Addington D, Kyle T, Desai S, Wang J: Facilitators and barriers to implementing quality measurement in primary mental health care: a systematic review. Can Fam Physician 2010, 56:1322-1331.
• [38]Ginsberg C, Sheridan S: Limitations of and barriers to using performance measurement: purchasers’ perspectives. Health Care Fin. Rev 2001, 22:49-57.
• [39]Veillard JH, Schiotz ML, Guiseet AL, Brown AD, Klazinga NS: The PATH project in eight European countries: an evaluation. Int J Health Care Qual Assur 2012, 26:703-713.
• [40]Luxford K, Safran DG, Delbanco T: Promoting patient-centered care: a qualitative study of facilitators and barriers in health care organisations with a reputation for improving the patient experience. Int J Qual Health Care 2011, 23:510-515.
• [41]Castelnuovo B, Kiragga A, Afayo V, Ncube M, Orama R, Magero S, Okwi P, Manabe YC, Kambugu A: Implementation of a provider-based electronic medical records and improvement of the quality of data in a large HIV program in sub-Saharan Africa. Plos One 2012, 7:e51631.
• [42]Kallander K, Tibenderana JK, Akpogheneta OJ, Strachan DL, Hill Z, ten Asbroek AH, Conteh L: Mobile Health (mHealth) approaches and lessons for increased performance and retention of community health workers in low-and middle-income countries: a review. J Med Intern Res 2013, 15:e17.
• [43]Leon N, Schneider H, Daviaude E: Applying a framework to assessing the health system challenges to scaling up mHealth in South Africa. BMC Med Inform Decis Mak 2012, 12:123. DOI:10.1186/1472-6947-12-123 BioMed Central Full Text
• [44]Tai B, McLellan T: Integrating information on substance use disorders into electronic health record systems. J Subst Abuse Treat 2012, 43:12-19.
• [45]Institute of Medicine: Bridging the gap between practice and research: forging partnerships between community-based treatment and research. Washington: National Academies Press; 1998.
• [46]Cullen AE, Coryn CLS, Rugh J: The politics and consequences of including stakeholders in international development evaluation. Am J Eval 2011, 32:345-361.