Routine Outcome Monitoring (ROM) is a new phenomenon in the mental healthcare system. Its introduction into daily clinical practice has not been straightforward. This study examines practical examples of the embedding of this innovation and its effective acceptance in clinical practice.

A case history illustrates how ROM was implemented in a large mental health hospital in The Netherlands. During implementation a number of weak points in the implementation process emerged. An intense analysis of the organization of the care process, in the context of care pathways and operations management, offered explanations of what went wrong in this case. Future improvements are suggested from an operations management viewpoint.

For the improved implementation of ROM in the mental healthcare sector implementation must be widely participatory, the process must be continuously monitored, and a leading, well-informed clinician must be appointed as process manager to guide the implementation process.