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Biomedical subjects

Gerard Schippers

Publications and source records attributed to Gerard Schippers.

3 recordsLinked to original sources

Evaluating treatment process redesign by applying the EFQM Excellence Model.

OBJECTIVE: To evaluate a treatment process redesign programme implementing evidence-based treatment as part of a total quality management in a Dutch addiction treatment centre. METHOD: Quality management was monitored over a period of more than 10 years in an addiction treatment centre with 550 professionals. Changes are evaluated, comparing the scores on the nine criteria of the European Foundation for Quality Management (EFQM) Excellence Model before and after a major redesign of treatment processes and ISO certification. RESULTS: In the course of 10 years, most intake, care, and cure processes were reorganized, the support processes were restructured and ISO certified, 29 evidence-based treatment protocols were developed and implemented, and patient follow-up measuring was established to make clinical outcomes transparent. Comparing the situation before and after the changes shows that the client satisfaction scores are stable, that the evaluation by personnel and society is inconsistent, and that clinical, production, and financial outcomes are positive. The overall EFQM assessment by external assessors in 2004 shows much higher scores on the nine criteria than the assessment in 1994. CONCLUSION: Evidence-based treatment can successfully be implemented in addiction treatment centres through treatment process redesign as part of a total quality management strategy, but not all results are positive.

Clinical Protocols↗

Development and validation of the Amsterdam Motives for Drinking Scale (AMDS): an attempt to distinguish relief and reward drinkers.

UNLABELLED: Determination of alcoholic subtypes is a promising strategy for patient treatment matching with anti-craving interventions. The aim of this study is to develop and validate a questionnaire on drinking motives that can distinguish relief and reward drinkers. METHODS: A 103-item self-report questionnaire was developed: the Amsterdam Motives for Drinking Scale (AMDS). The AMDS was tested in two samples of alcoholics (Sample A: n = 251; Sample B: n = 197). The psychometric properties were examined in Sample A and cross-validated in B. RESULTS: The AMDS consists of a relief scale and a reward scale, both containing distinct subscales. All (sub)scales had good internal consistency. However, the relief and reward scales were highly correlated (Sample A: r = 0.84, P < 0.01; Sample B: r = 0.76, P < 0.01), and convergent and divergent validity was only partly confirmed. The lowest correlations were found between the relief subscale 'stress and vulnerability' and the reward subscale 'stimulation seeking' (Sample A: r = 0.33, P < 0.01; Sample B: r = 0.13, P > 0.01). CONCLUSIONS: The AMDS reliably measures two types of motives. However, the relief and reward scales are highly correlated. Lower correlations were found only at the subscale level. It is concluded that most treatment-seeking alcoholics have both relief and reward motives. More research is needed on the relationship between motives for drinking and other phenotypic, endophenotypic and genetic indicators of relief and reward drinking, and appropriate cut-off points. Only than we can draw firm conclusions regarding the potential of drinking motives for patient treatment matching.

Adult↗