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Evaluating

Evaluating. Agenda:. Why is evaluating difficult? Developing an evaluation framework The evaluation timeline. §1 Why is evaluating difficult?. h aving data. patients w/ complexities = complex intervention. f inding an appropriate comparison group. ~. ~. regression to the mean.

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Evaluating

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  1. Evaluating

  2. Agenda: Why is evaluating difficult? Developing an evaluation framework The evaluation timeline

  3. §1 Why isevaluatingdifficult?

  4. having data

  5. patients w/ complexities = complex intervention

  6. finding an appropriate comparison group ~ ~

  7. regression to the mean

  8. regression to the mean

  9. it takes time! 12 11 1 10 2 3 9 8 4 7 5 6

  10. §2 Developingan evaluationframework

  11. Process Outcomes

  12. Customized Data System Solutions

  13. Dashboards

  14. Problem The stated goal of our intervention was to see our patients once a week in person. Too many failures were occurring and our relationship with patients was diluting 168 DAYS Actions Taken • Weekly scorecard to measure success and failure • Daily operations dashboard to identify opportunities • Weekly root cause deep dives by management team Results • Reduced median days since last engagement • Dramatically reduced process variability & outliers 38 DAYS Days Since Last In-Person Engagement WEEK 1 WEEK 10

  15. Numberof 6x month readmissions by enrollment date

  16. §3 Choosingan appropriateevaluation timeline

  17. Program Timeline Piloting and Early Evaluation Scaling Planning & Data Analysis More Robust Evaluation (through Randomization)

  18. Medical Studies 80%

  19. Healthcare Delivery Studies 20%

  20. Clear, credible results on causal effectsHelpful in attracting sustainable funding and scaling a program Why? Timing – not too early and not too lateTime, expertise, and funding to do it right When? Sample SizeNumber of treatment arms Randomizing before or after consent?Data (what’s collected administratively?-available for the control group? Key Issues

  21. CCHP’s Care Management RCT Standard of Care Key Outcomes: reduced re-hospitalizations and ED visits in 12 month period following discharge n = 138 / 800

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