From Output to Outcome: Quantifying Care Management

1. From Output to Outcome: Quantifying Care Management Kelly A. Bruno, MSW and Danielle T. Cameron, MPH National Health Foundation Background identify ongoing output, resulting outcomes and how to operationalize each. NHF utilized internal resources to design and program a web-based data collection system to capture and report on this information. Discussion National Health Foundation has developed a partnership with the Specialized Ambulatory Geriatric Evaluation (S+AGE) Center at Sherman Oaks Hospital, which is designed to help seniors, caregivers and medical professionals deal with the changes associated with aging through targeted diagnosis and management. This partnership has resulted in the design and implementation of a web-based data collection and evaluation system, which provides S+AGE staff members with the ability to track client and caregiver information and program impact. This system has resulted in a better understanding of senior healthcare delivery systems and the impact S+AGE is having on healthy aging and caregiver stress. Ultimately, S+AGE has utilized these outcomes to improve services, promote awareness of its programs, and increase access within their community. This partnership was in direct response to the philanthropy communities’ burgeoning desire for agencies to conduct evaluation and demonstrate meaningful impact of their financial support. In the current frenzy over accountability, funders and stakeholders are requiring programs to demonstrate measurable outcomes for the clients they serve. Although successful in collecting output data, few care management agencies have the resources necessary to turn those output data into meaningful statements about true program impact. Instead, these agencies often collect copious amounts of useless data, draining resources that would otherwise be directed toward client service. This partnership has demonstrated an innovative technological method to capturing, monitoring and evaluating care management service provision data. The outcomes of this partnership have positioned S+AGE, and have the capacity to position other agencies, to improve internal operations, demonstrate to the community programmatic impact, and ultimately, secure additional funding. Measures S+AGE utilizes a variety of measurements to gauge the health of their clients. In particular, they wanted to measure: In order to measure these outcomes, S+AGE captured client data at each office visit using: Results • General health and demographic data of clients; • The impact of their care management services on caregiver stress; and • The impact of their care management services on caregiver depression. NHF produced a comprehensive, unique data collection system for S+AGE staff members to digitize their client records. Furthermore, S+AGE is given the ability to monitor program output (such as number and type of interventions and referrals given over a certain time period), and track patient outcomes (such as improvement in depression as correlated to completion of referrals). While actual results of S+AGE’s interventions are still unknown (due to time necessary for interventions to have an effect), S+AGE staff members will be able to use the pre-programmed reporting functions to monitor outcomes over time. Objectives • American Medical Association’s Caregiver Self Assessment (to measure stress); • PHQ-9, a nine item depression scale of the Patient Health Questionnaire; and • A checklist of interventions and referrals given. • Differentiate between outputs and outcomes in care management program. • Learn about technological methods to capture, monitor and evaluate service provision data. • Learn to implement these strategies to improve the organization's program performance and broaden outreach. Conclusion The technological tools and methods featured in this session can be successfully replicated in health and social services agencies across local regional and national settings. Contact NHF to learn more about opportunities for partnership. Methods NHF collaborated with S+AGE to conduct a comprehensive review of services and current data collection methods. NHF facilitated discussion among S+AGE staff members to This project was funded by: Circle of Care Foundation