As part of Carolina Center’s Performance & Quality Improvement Plan (PQI), we perform an annual program evaluation study for submission to the Quality Assurance Committee as a part of the annual Program Evaluation Summary. This study will include an analysis of consumer outcome and statistical data to determine program effectiveness and efficiency. The annual report will be used for quality assurance monitoring of consumer services provided by Carolina Center for Counseling. To accomplish this, the following outcomes were tracked for the 1/1/20 – 12/31/20 reporting period to ensure the highest quality of care for services provided as well as treatment efficacy to Carolina Center’s consumers.

Global Assessment of Functioning (GAF):

The Global Assessment of Functioning (GAF) is used as an outcome to report clinical staff’s judgment of a consumer’s overall level of functioning. This information is particularly useful for treatment planning, measuring its impact, and predicting treatment outcome. The GAF can be helpful in tracking the clinical progress of consumers in global terms, using a single measure. Carolina Center for Counseling utilizes the GAF to track the clinical progress of consumers in respect to their psychological, social, and occupational functioning.  As part of Carolina Center’s PQI Plan, it is tracked and updated continuously throughout treatment and used to measure the overall functioning of consumers at the time of admission and discharge.

A total of 129 discharges occurred for the 2019 reporting period. Of the 129 consumers discharged, 90 consumers (or 70%) showed improvement in their overall functioning as evidenced by an increase in consumer’s individual discharge GAF score compared to intake GAF score. Similarly, 37 consumers (or 29%) showed no significant changes to their overall functioning as evidenced by Discharge GAF score remaining the same as intake GAF score. Finally, 2 consumers (or 1%), showed a decrease in their discharge GAF score when compared to their intake GAF score.  The following table illustrates the overall respective GAF scores:

Table 1 – GAF Discharge Scores 2019

Table 2 – GAF Discharge Scores—2020 vs. 2019

As is evident from the above comparisons, overall clinical effectiveness as measured by an increase in GAF score from admission to discharge seems to be the same in 2020 as in the past year of 2019.  Similar to the last year, the trend seems to be we have the same percentage getting better from Admission to Discharge, the same staying the same, and very few getting worse.  As in the past we see that the vast majority of our consumers come here and leave being better or same, and very few consumers came here for help and ended up getting worse. As in the past, each of these “Worse” cases was reviewed and they were either referred for a higher level of care, moved away, or were noncompliant with treatment and did not respond to attempts to engage them.

Consumer Satisfaction Survey

The Consumer Satisfaction Survey is a tool designed to measure the consumer’s opinion of the services they receive, effectiveness of person-centered planning and service delivery, clinical efficacy, relationship of the agency to its consumer base, and to assure continuity of improvement with a long term goal of less than 10% of consumer sample responding in a negative manner. Similar to the GAF, the Satisfaction Survey is used to measure the overall effectiveness of Carolina Center and its services, but on a broader scale.

In an effort to ensure that Carolina Center maintains the standard of serving the consumer with services in the manner that the consumer desires, the agency offers its consumers the opportunity to submit a response to a consumer satisfaction survey one time per year. The Survey is graded with five (5) standards (excellent, very good, good, fair, and poor), in which the consumer can judge several aspects of services provided by Carolina Center and its staff. Those areas are:

Quality of Services

Therapist

Courtesy of staff

Hours of Operation

Safety and Cleanliness

Progress with Treatment

There are spaces for comment after the questions. Additionally, this survey has two salient questions for the consumer:

1. Considering there are other choices, do you still want services from this agency? And,
2. Do you have recommendations on how we can improve our services?

Each of these questions has a space provided for comments. Finally, the survey provides the

opportunity for the consumer to be contacted to discuss their comments and to express additional

concerns and recommendations. However, this is optional as the survey is anonymous if the

consumer desires.

The data from 2019 is included in this report for baseline purposes to compare and contrast differences from 2019 outcomes.

August 2020 – Consumer Satisfaction Survey

A total of 17 consumers completed the Consumer Satisfaction Survey in August 2020.

Of those respondents, a total of 12 (or 71%) consumers rated the Quality of Services as Excellent or as Very Good, and none rated as being Good, Fair, or Poor.

In examining consumer satisfaction with their Therapist/Staff/Worker, a total of 14 (or 82%) consumers rated them as Excellent or Very Good, and none rated as being Good, Fair, or Poor.

A total of 14 (or 82%) consumers rated the Courtesy of Staff as Excellent or Very Good, and 3 (18%) rated this as being Fair and 0 as Poor.

For Hours of Operation, a total of 12 (or 71%) consumers rated this as Excellent or Very Good, 3 (18%) as Good, and 0 rated this as being Poor.

A total of 15 (or 88%) consumers rated Safety and Cleanliness of the Environment as Excellent or Very Good, and none rated as being Good, Fair, or Poor.

For Progress with Treatment, a total of 16 (or 94%) consumers rated this as Excellent or Very Good, 1 (or 6%) as Good, and none rated this as being Fair or Poor.

A total of 17 (or 100%) consumers answered “yes” in regards to whether they would choose Carolina Center again for services, and 1 (or 2%) answered “no.”

December 2019 – Consumer Satisfaction Survey

A total of 46 consumers completed the Consumer Satisfaction Survey in October–December, 2019.

Of those respondents, a total of 46 (or 100%) consumers rated the Quality of Services as Excellent or as Very Good, and none rated as being Good and none as Poor.

In examining consumer satisfaction with their Therapist/Staff/Worker, a total of 46 (or 100%) consumers rated them as Excellent or Very Good,  and none as Good, Fair, or Poor.

A total of 45 (or 98%) consumers rated the Courtesy of Staff as Excellent or Very Good, and 1 (2%) rated this as being Good with 0 as Poor.

For Hours of Operation, a total of 45 (or 98%) consumers rated this as Excellent or Very Good, 1 (2%) as Good, and 0 rated this as being Poor.

A total of 46 (or 100%) consumers rated Safety and Cleanliness of the Environment as Excellent or Very Good, none rated this as being Good, Fair, or Poor.

For Progress with Treatment, a total of 41 (or 89%) consumers rated this as Excellent or Very Good, 5 (or 11%) as Good, and none as Fair, or Poor.

A total of 45 (or 98%) consumers answered “yes” in regards to whether they would choose Carolina Center again for services, and 1 (or 2%) answered “no.”

Incident Report Data

During calendar year 2020, there were a total of zero incident reports involving consumers of Carolina Center for Counseling.  All incidents were reported electronically to the State through the Incident Response Improvement System within the required timelines.  All other required reporting was made within a timely manner.  The incidents are categorized as follows:

During calendar year 2020 we had no formal complaints from any source.

Summary

 GAF

As is evident from the above comparisons between 2019 and 2020, overall clinical effectiveness as measured by an increase in GAF score from admission to discharge continues to be very good. As has been noted in past discussions, the vast majority of consumers in our care are getting better or staying the same with very few getting worse while they are in treatment at Carolina Center.  We have 99% of our consumers getting better or staying the same while in our care and a very low number of consumers getting worse. Of those few who do get worse, they are referred to higher levels of care, are transferred, or are noncompliant inspite of our efforts to engage, assist, or refer out. Overall, we seem to have significantly more getting better from Admission to Discharge, fewer staying the same and we are maintaining very few getting worse while in treatment at Carolina Center.

Consumer Satisfaction Survey

Our overall trend for the 2020 Consumer Satisfaction Survey continue to show favorable outcomes in terms of consumer satisfaction among all of the areas listed on the survey including quality of services, rating therapist, courtesy of staff, hours of operation, safety and cleanliness of offices, progress of treatment, and would they choose us again. As we have noted many years, Quality of Service ratings of Excellent and Very Good continue to comprise 100% of our quality ratings.  Overall satisfaction with Therapist/Staff/Worker ratings continue to be rated as Excellent and Very Good.  Our staff continue to be our best asset and their high ratings reflect that. Hours of Operation continue to be well rated by our consumers and seem to indicate little concerns with our hours of operation or consumers chances to get appointments that meet their needs. In regards to Safe and Clean Environment, the entire consumer sample rating this either Excellent, or Very Good and is another very good finding. Results from Progress with Treatment showed that 100% of our consumer sample rated this Excellent, Very Good, or Good this last year.  Our final question showed that 98% of our consumer sample answered “yes” in regards to whether they would choose Carolina Center again for services with only 1 consumer answering no.

Incident Report Data

Considering the number of consumers served by this agency and the frequency of services, zero incidents are, as we have seen in our past data, rather low for the size of the agency. This was less than last year and continues to be almost entirely a product of our PSR program. As in the past, an interpretation that the very low level of Level II Incidents continues to be an indication of staff expertise and the very diverse clinical population at PSR. Additionally, having no formal complaints speaks very highly of an extremely busy agency serving a complex and diverse consumer population.