The purpose of this article is to describe a procedure to assist in selecting outcome measures for inpatients treated at a state psychiatric hospital. The procedure combines evidence-based criteria from the literature, instruments shown to be sensitive to change in clinical trials, and the perspectives of a multidisciplinary team of researchers, administrators, providers, and patient advocates. Recent efficacy and effectiveness studies were used to identify recurrently used outcome instruments. A computerized search of more than 30 bibliographic databases, such as PsycINFO, MEDLINE, Social SciSearch, and ERIC, was conducted for articles published between 1990 and 2002. Comparisons of the most frequently used instruments were made on seven criteria proposed as best-practice indicators, including sensitivity to change and robust psychometrics. The sample produced 110 measures. Rater-completed instruments were represented more often than patient-completed ones. However, considerable variability across both methods was found on the criteria. The limited resources associated with publicly funded inpatient facilities led to a recommendation to select at least one rater-completed and one patient-completed instrument.

The Brief Psychiatric Rating Scale (BPRS) is the most commonly used outcome measure for the severely and persistently mentally ill (SPMI) population, possessing good interrater reliability, concurrent validity, and a strong factor structure. However, psychometric study of the extended version of the BPRS (the BPRS-E) is limited when compared with earlier versions (BPRS and BPRS-A). This study examined the item, factor, and diagnosis-specific sensitivity to change of the BPRS-E, the most recent version of this popular scale. Assessments were conducted at 90-day intervals with 201 adult psychiatric inpatients at the Utah State Hospital, yielding 786 symptom ratings. Of note was that ratings were conducted by independent assessors who were unaware of patients' treatment status. All but 2 of the 24 BPRS-E items, all 4 factors, and the total score were found to be sensitive to change when comparing patients' admission and discharge scores. Patient diagnosis was not associated with item, factor, or total score sensitivity to change. These findings extend the psychometric support for the BPRS-E and have implications for assessing outcome with the SPMI population.

This article describes the collaborative effort of a team of discipline directors, administrators, and academicians to create a systematic program to enhance the group competencies of a large clinical staff working at a state hospital. The effects of the program were tested by a quasi-experimental field study. Quantitative measures of group process provided limited support for program effectiveness. Stronger support came from qualitative inquiry. The development and effectiveness of the program is examined within a larger context of group programs housed in large health care organizations.

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<h4></h4> <p>Although a great deal has been written about the importance of patient education, few replications of past research have been conducted to increase clinicians&rsquo; confidence in the conclusions of previous studies. This is especially true of studies conducted in clinical settings where findings may or may not be generalizable to other institutions. This partial replication study tested whether previous findings about patient education in an outpatient setting were applicable to an inpatient setting using a modified version of the instrument. A 1998 study published in this journal suggested that differences may exist between the perceived health education needs of outpatients and their health care providers. In this partial replication, we examined the differences between the educational needs of inpatients and those perceived by their attending nurses. As in the original study, we found discrepancies between patients&rsquo; actual needs and nurses&rsquo; perceptions of those needs, supporting the importance of assessing patients&rsquo; health educational needs in the treatment planning process.</p>