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Can we improve outcomes?

Prepared by: Jeb Brown; 10/19/2011

We are often asked how much can outcomes be improved with outcomes informed care? The answer depends on a number of factors, including the quality of clinical leadership in the organization. It takes some time for organizations to develop a truly outcomes informed clinical culture. For organizations using the ACORN tools, improved outcomes are associated with consistency of use of the outcome questionnaires and frequency of clinicians logging into the Toolkit.

The following graph displays the Severity Adjusted Effect Size based on the number of years an organization has used the ACORN tools. All organizations using the Tools are included. Organizations include private for profit mental health practices, non-profit organizations serving Medicaid and other publicly funded populations, Employee Assistance Programs, and staff model HMOs. All organizations are included in the analysis, regardless of the number of years they have employed ACORN.

Patients were assigned to a year based on the number of years between the date of their last assessment and the date the organization first began to use the ACORN questionnaires. After controlling for variables such as diagnosis, severity at intake, length of time and treatment and number of assessment per episode of care, the upward trend in effect size is statistically significant (p<.01). The two strongest predictors of year over year improvement for individual clinicians are the number of cases measured and the frequency at which the clinician uses the Toolkit to view results.

YearsOfUseAndOutcomes.jpg

The following displays based on classification of change status. Patients who change exceeds the Reliable Change Index are classified as significantly improved or worse, while patients who change exceed the Standard Error of Measurement are classified as somewhat improved or worse.

ChangeStatusByYear.jpg

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