Performance measures for early psychosis treatment services

Objective: This study examined the feasibility of identifying performance measures for early psychosis treatment services and obtaining consensus for these measures. The requirements of the study were that the processes used to identify measures and gain consensus should be comprehensive, be reproducible, and reflect the perspective of multiple stakeholders in Canada. Methods: The study was conducted in two stages. First a literature review was performed to gather articles published from 1995 to July 2002, and experts were consulted to determine performance measures. Second, a consensus-building technique, the Delphi process, was used with nominated participants from seven groups of stakeholders. Twenty stakeholders participated in three rounds of questionnaires. The degree of consensus achieved by the Delphi process was assessed by calculating the semi-interquartile range for each measure. Results: Seventy-three performance measures were identified from the literature review and consultation with experts. The Delphi method reduced the list to 24 measures rated as essential. This approach proved to be both feasible and cost-effective. Conclusions: Despite the diversity in the backgrounds of the stakeholder groups, the Delphi technique was effective in moving participants' ratings toward consensus through successive questionnaire rounds. The resulting measures reflected the interests of all stakeholders.