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Table 5 Performance indicators guideline adherence and their criteria 1 = deviant care, NA = Not applicable

From: Design of a randomized controlled trial on the effects of Counseling of mental health problems by Occupational Physicians on return to work: the CO-OP-study

PI 1 Assessment of symptoms Score
Criteria: 1. Presence or absence of essential symptoms of anxiety disorder and depressive disorder should be noted in file  
  2. Presence or absence of distress symptoms (fatigue, concentration problems, sleeping problems, and emotional reactivity) should be noted in file  
  One or both criteria not met within 2 consultations? PI1 = 1
PI 2 Correct diagnosis  
Criteria: 1. Diagnosis should be noted in file  
  2. Diagnosis should be correct:  
  - IF adjustment disorder: at least one psychological distress symptom should be noted in file  
  - IF depressive disorder: at least one essential symptom AND five depressive symptoms should be noted in file  
  - IF anxiety disorder: at least one anxiety disorder should be noted in file  
  3. Diagnosis should not be missed if criteria above apply  
  One or more criteria not met within 2 consultations? PI2 = 1
PI 3 Evaluation curative care  
Criteria: 1. Treatment in the curative sector, or its absence, should be noted in file  
  2. IF patient receives treatment, THEN the OP should evaluate whether this treatment is effective  
  One or both criteria not met within 2 consultations? PI3 = 1
PI 4 Assessment work-related causes  
Criteria: 1. the work-related causes, or their absence, should be stated in file  
  One or both criteria not met within 2 consultations? PI4 = 1
PI 5 Evaluation of work disabilities  
Criteria: 1. Functional limitations in home or work environment, or their absence, should be stated in file.  
  2. Work activities of patient should be noted by OP  
  3. OP should assess whether patient is limited in his work functioning  
  4. IF patient has work limitations, THEN OP should assess other impediments for return to work (such as problems in home situation or with supervisor)  
  One or both criteria not met within 2 consultations? PI5 = 1
PI6 Interventions targeted at individual  
  1. Intervention aimed at the individual should be noted or be referred
- IF adjustment disorder, THEN OP should start interventions OR should refer patient to psychologist/social worker/general practitioner OR should consult with practitioner giving current treatment
- IF anxiety disorder OR depression OR other psychiatric disorder, THEN OP should refer patient to psychologist/social worker/general practitioner OR should consult with practitioner giving current treatment
 
  Criterion not met within 3 consultations? PI6 = 1
PI7 Interventions targeted at organisation  
  IF work is a causal, eliciting or maintaining factor in the mental health problem, THEN OP should intervene in the work organisation (confer with supervisor/personnel officer)  
  Criterion not met within 3 consultations? PI7 = 1
  IF work is neither causal, eliciting nor maintaining factor in mental health problem PI7 = NA
PI8 Interventions targeted at providers of care in curative sector  
  1. IF treatment in curative sector is lacking and deemed necessary, THEN OP should start interventions targeted at the individual OR refer patient to psychologist/social worker/general practitioner  
  2. IF treatment in curative sector is not effective, THEN OP should consult with practitioner giving current treatment  
  One or both criteria not met within 3 consultations? PI8 = 1
  IF patient receives effective treatment in curative sector PI8 = NA
PI9 Advice on return to work  
  1. Advice on return to work should be provided by OP  
  2. IF no impediments for return to work are present, THEN OP should advise full or partial return to work  
  One or both criteria not met at each consultation? PI9 = 1
  Patient already (partially) returned to work? PI9 = NA
PI10 Timing of consultations  
  1. First consultation should be within 3 weeks from first day of sickness absence  
  2. IF patient has not yet completely recovered, THEN next consultation should be within 4 weeks from previous consultation  
  Criterion 1 not met at first consultation OR criterion 2 not met at consultation 2 or 3? PI10 = 1