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Performance and Outcome Measurement

Performance and Outcome Measurement. Mady Chalk, Ph.D. Treatment Research Institute November, 2007. Background. Urgency of need for measuring quality using performance measures has been identified by the IOM in its recent report and by the work of the National Quality Forum (NQF)

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Performance and Outcome Measurement

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  1. Performance and OutcomeMeasurement Mady Chalk, Ph.D. Treatment Research Institute November, 2007

  2. Background • Urgency of need for measuring quality using performance measures has been identified by the IOM in its recent report and by the work of the National Quality Forum (NQF) • Systematic reviews have been conducted by the Cochrane Collaborative and TRI (about 65 separate reviews) and a research synthesis has been created of over 350 controlled clinical trials (the Mesa Grande project)

  3. What Are Performance Measures? PERFORMANCE MEASURES ARE USED AT THE TREATMENT PROGRAM LEVEL FOR QUALITY IMPROVEMENT

  4. Performance Measurement • Performance of treatment programs in providing access and timely access to treatment and retaining patients in treatment • Performance of healthcare plans in identifying individuals with substance use disorders and whether they initiate and engage in treatment

  5. Performance Measurement • Performance of clinicians in providing direct treatment services and an access channel to other service systems, i.e. “practice performance” • Regular tracking of program performance is a keystone for identifying where significant problems exist and service improvement needs to occur

  6. Performance Measurement • Performance measures of time to treatment (timely access) when combined with engagement might collectively be considered an efficiency measure Monitoring during treatment must be a continuous process for measuring performance

  7. What Are Outcome Measures? OUTCOME MEASURES ARE USED AT THE PATIENT LEVEL FOR ACCOUNTABILITY AND TRENDS OVER TIME

  8. Outcome Measurement • Functional status of patients during treatment related to substance use, health, mental health, employment, criminal behavior, family relationships • Functional status of patients at critical points as they prepare to move from one level of care to another

  9. Outcome Measurement • Outcomes of different treatment organizations can be benchmarked (regardless of how they are achieved); outcome measures give you a “running score” but cannot tell you why the score is the way it is • Internal and external factors affect outcomes, factors that may be out of the control of an agency or program

  10. Selecting Performance Targets • What do you want to change (improve) and why do you want to change (improve) it? • Criteria include: relevance and importance to improving treatment services, feasibility of collecting data on the measure, relationship to end outcome

  11. Choosing Measures • Specifying performance measures and selecting which measures to monitor is crucial • Some of the most important performance and outcome measures will require new data items and data collection procedures

  12. Possible Performance Measures • Treatment Initiation (within 14 days) • Treatment Engagement (within 30 days) • Treatment Retention (90 days) • Continuity of Care Measures • Treatment “Completion” • NIATx Measures • Others?

  13. In Summary • Performance measures and outcome measures are defined and used differently • It is important not to confuse the how performance and outcome measures can best be used

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