What is the system challenge?

In the mental health and addictions system, a client’s perception is widely seen as a key indicator of the quality of the care. Though many organizations gather feedback from clients using a variety of tools, there is no consistent way that this information is collected and reported. Since there is so much variation in the types of client feedback surveys, the information gathered cannot adequately be used to guide quality improvement efforts at the program/service and system levels.

What are we doing about it?

The Provincial System Support Program at CAMH developed and validated the Ontario Perception of Care Tool for Mental Health and Addictions (OPOC-MHA). This evidence-based tool standardizes how substance use, mental health, and concurrent disorder services obtain client perception of care feedback, which can in turn be used to make valuable service improvements. The OPOC-MHA survey meets the need for a standardized perception of care tool for informing, monitoring, and evaluating quality improvements and provides a consistent way to gather client feedback in both community and hospital settings. This brings the client voice forward as a source of evidence to support program, agency, and system quality improvement efforts.

There are currently two versions of the standard OPOC-MHA — registered and non-registered. The registered version is suitable for most clients receiving services, while the non-registered can be used for individuals who are receiving support but are not registered to a program, for example family members or non-registered clients of a drop-in program. There are also three customized versions of the OPOC-MHA: caregiver; supportive housing; and crisis support. All versions are available in English and French.

The client’s perception of care is gathered across several quality domains, with an opportunity for written comments following each domain. Demographic information is also collected to help organize the information and identify potential inequities in service.

A central provincial database and reporting portal gives organizations access to OPOC-MHA results, which can be filtered and analyzed in a customized manner. For example, organizations can select specific indicators they wish to track over time, examine data through a health equity lens, and then look at specific programs to support quality improvement efforts. Organizations also have access to aggregated, comparable provincial data.

Evaluating client perception of care data is an important way to measure client experience within the health care system. Items on the OPOC-MHA can be used to bring about necessary service change in areas such as access, quality of care, and safety. More broadly, system planners and funders can utilize results of providers to identify system-level quality improvement opportunities.

Who is involved?

All publicly-funded addiction, mental health, and concurrent disorder service providers in Ontario are involved in OPOC-MHA, including both hospital and community-based programs.

Next Steps

OPOC-MHA implementation continues across the province. The measure is also providing a foundation for collaborative quality improvement endeavors – check out the Continuous Quality Improvement Collaborative