About the Fidelity Scale
The First Episode Psychosis Services Fidelity Scale (FEPS-FS)
Addington D. ©
The First Episode Psychosis Services Fidelity Scale (FEPS-FS 1.0) is a scale that has been developed to assess the degree to which First Episode Psychosis Services (FEPS) deliver evidence based practices. Program fidelity has been defined as the extent to which delivery of an intervention adheres to the protocol of an evidence-based program model and fidelity scales provide a list of objective criteria by which a program is judged to adhere to a reference standard for the intervention. The FEPS-FS 1.0 comprises 35 items, covering early identification, access, assessment, pharmacological and psychosocial evidence based practices and team functioning.
The FEPS-FS was originally developed using formal knowledge synthesis processes including, systematic reviews, rating of supportive evidence and an international expert consensus process to identify the essential components. The scale has been used in Canada, the United States and Europe and can be rated by trained raters using site visits or remote assessment or by programs as a self report measure. It can be used for assessing a single site or a network of sites. The published studies suggest that the scale is feasible to apply, has face validity and is highly reliable in the hands of trained raters. The focus of the scale is the services delivered to the patients served by a program and it has been successfully used to compare services across differing health systems and different program models. Compared with other published scales it has fewer items, and a higher proportion of the items that are common to all the scales.
The scale needs to be used in conjunction with the rating manual. The raters need to be trained and familiar with the scale and the rating manual.
The scale has been used for quality improvement and quality assurance as an outcome measure for implementation studies and as an intervening variable for clinical outcome studies. It is being used by funders as a tool to support quality assurance. New applications to assess services for Clinical High Risk of Psychosis and those with Bipolar Disorder are being tested.
Training involves a two day training program that can be delivered remotely, followed by a teleconference review of the first few fidelity assessments to ensure reliability in practice.
The Scale and Manual can be accessed at https://press.ucalgary.ca/books/9781773852089. This book is available as an eBook which is licensed under a Creative Commons license. The copyright owner should be contacted for any commercial use which falls outside the terms of the following license: CC NC-ND (Creative Commons: Non-Commercial No Derivatives).
For training or permission to use the FEPS-FS-1.0 (© 2015 Dr. Donald E. Addington) contact Dr. Addington at addingto@ucalgary.ca.
Dr. Donald Addington
MBBS, MRCPsych, FRCPC
Professor, University of Calgary
Alternate Sites:
www.hbi.ucalgary.ca/profiles/dr-donald-addington
www.ucalgary.ca/cdss/