A comparison of the National Clinical Audit of Psychosis 2019/2020 standards and First Episode Psychosis Services Fidelity Scale 1.0. Issue 9 (9th December 2021)

• Record Type: Journal Article
• Authors: Addington, Donald; French, Paul; Smith, Jo
• Is Part Of: Early intervention in psychiatry. Volume 16:Issue 9(2022)
• Page Start: 1028
• Page End: 1035
• Publication Date: 2021-12-09
• Subjects: clinical audit -- early medical intervention -- implementation science -- psychotic disorders -- quality indicators; Mental health -- Periodicals; Psychiatry -- Periodicals; Psychiatry -- Research -- Periodicals; Mental illness -- Prevention -- Research -- Periodicals; Mental illness -- Treatment -- Research -- Periodicals; 616.89
• DOI: 10.1111/eip.13262
• Languages: English
• ISSNs: 1751-7885

Abstract

Abstract: Aim: The authors compare two approaches to assessment of the quality of early psychosis intervention services, the National Clinical Audit of Psychosis used in the United Kingdom and the First Episode Psychosis Services Fidelity Scale used in North America and Europe. Methods: We compare the two approaches on the source of standards, measurement type, data collection, time requirements, scoring and reliability. Finally, we review their strengths and limitations. Results: Both measures are based on standards derived from the same research evidence base. Both methods rely on data from health records and administrative data. The audit is supplemented with user survey data, the fidelity scale with clinician interviews. The audit requires more time. The audit is based on quality indicators rated as present or absent which yields a statistical benchmark. The Fidelity Scale is based on quality indicators that are rated on a five‐point scale yielding a standards‐based measure. The two methods cover similar service components, but the FEPS‐FS has a broader coverage of team functioning. The National audit also collects data on the user experience directly from patients. The fidelity scale has achieved good to excellent inter‐rater reliability, the reliability of the audit has not been tested. Conclusions: Both methods have face validity and provide reliable and useful measures of quality of care. The NCAP works in the context of a single provider health system, the FEPS‐FS works in a more variable health system. Comparing the two systems in the field would support international comparison of standards of care.