Performance Measurement & Quality Improvement

We are the experts in behavioral healthcare performance measurement


Performance measurement has been a fundamental activity of NRI since its inception in 1987.


The first landmark event was the 1997 formal framework for performance measures developed with the state mental health agencies to address concepts of access to care, appropriateness of care, quality of care, and outcomes of care. Measures were developed within each of these areas and a foundation for consistent measurement across providers of mental health services was laid. Benchmarking performance, determining optimal levels and best practices, could be used to promote high quality care and better outcomes for persons served by the public mental health system. The effort led to the collaboration with SAMHSA in the development and testing of numerous measures for public accountability, quality, fidelity, and the National Outcome Measures.


The second landmark event was the 1999 listing of NRI’s performance measurement system by The Joint Commission as meeting the criteria for inclusion in the accreditation process and NRI's inclusion on The Joint Commission’s list of acceptable ORYX vendors. NRI is committed to meeting future required criteria established by The Joint Commission. NRI successfully developed and implemented 24 performance measures for inpatient psychiatric care. It was through the Behavioral Healthcare Performance Measurement System (BHPMS) that NRI began the collaboration with the National Association of Psychiatric Health System to develop and test common performance measures for public and private psychiatric facilities. The effort led to the collaboration with The Joint Commission in the development of the first core measure set for inpatient psychiatric care, Hospital Based Inpatient Psychiatric Services (HBIPS) core measure set.


Ultimately, the goals of performance improvement are:


  • near-perfect performance

  • identifying shortcomings, and

  • addressing process issues related to the identified shortcomings


While aggregate data can help identify shortcomings, the utilization of local dis-aggregate data is essential to identify the clinical processes needing improvement, in order to provide patients with the highest standard of care.


NRI commits to the involvement of stakeholders in the development of performance measures. Measures used for accountability of organizations must include clinically relevant indicators and consumer-focused outcomes. Measures must be assessed for feasibility and burden and weighted against the benefits of metrics to improve processes and outcomes. NRI has assisted states agencies, professional organizations, and providers in their movements toward meaningful metrics to improve the lives of persons served.


For a free sample of our monthly publication, entitled Technical Notes, dedicated to the education of our members, you may click here.


Please contact for more information.