A chart-Review checklist for Utilization Review in a Community Mental Health Center

As an aid to utilization review in a community mental health center, a checklist has been developed that nonclinical personnel can use to help assess the adequacy of patient care, as reflected in the medical chart. The review is carried out on three levels. All charts are reviewed in the records room to make sure that all necessary forms are complete. On charts selected for more intensive review, the nonclinician reviewer responds to a series of yes-no questions about the quality of care or adequacy of information. If short-comings are found, the chart is then reviewed by a senior clinician to determine whether the care is in fact inadequate. The utilization review committee discusses instances of inadequate care with the clinician involved in the case, and also reviews with the administration any policy issues raised by the problems uncovered.