Abstract
This special section presents the psychometric properties of fidelity scales used in a national mental health services project in Norway to improve the quality of care of people with psychoses. Across Norway, 39 clinical units in six health trusts participated. The project provided education, implementation support and fidelity assessments. The papers in the section address the psychometrics of fidelity measurement for the specific evidence-based practices: illness management and recovery, family psychoeducation, physical healthcare and antipsychotic medication management. Another paper analyzes the psychometrics of a scale measuring individualization and quality improvement that may be used in conjunction with fidelity scales for specific evidence-based practices. The first paper in the section presents the development and field of fidelity scales, and the two final papers with comments add some additional perspectives and discuss fidelity scales in a wider context. The psychometrics of the five scales were good to excellent. Fidelity assessment is a necessary and effective strategy for quality improvement.
Highlights
Background for the Special Section onFidelity ScalesEvidence-based practices and clinical guidelines can improve the quality of treatment in health care, including for people with psychoses
The National Evidence-Based Practices (EBP) Project in the U.S demonstrated a standardized method for development and format of fidelity scales (Bond et al 2009) and methods for testing the properties for such scales (McHugo et al 2007)
Two trained experts assessed fidelity of both practices at each site at baseline and after 6, 12, and 18 months using independent and consensus ratings. The papers in this special section report on psychometric properties of the fidelity scales for all practices at sites that received implementation support
Summary
Evidence-based practices and clinical guidelines can improve the quality of treatment in health care, including for people with psychoses. Accurate implementation of evidence-based practices and clinical guidelines in routine healthcare remains problematic. Fidelity scales are tools to assess the quality of implementation in a program or clinical unit and guide improvements. “The rationale for using fidelity scales to guide practice is based on the working hypothesis that programs successfully replicating the core principles and procedures of the program models rigorously evaluated in controlled studies. Few studies of the psychometric properties of currently available fidelity scales exist. The papers in this special section address that deficit
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