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What to measure and why

What to Measure

The question of what to measure is relatively simple to answer once we understand why we are measuring. In this topic we will focus on two important goals of measurement: evaluation and performance improvement. For more on this topic see What to Measure.

Measure to Evaluate

A "measure to evaluate" approach seeks to measure the amount of improvement for a specific sample during a specified period of time. The purpose is to evaluate the efficacy or effectiveness of the treatment as delivered. Data generated through evaluative measures may be used to make comparisons (e.g., between treatments, organizations, providers), as an indicator of quality (e.g., evaluating performance against an expected standard or threshold) or to address accountability within a system. Generally speaking, evaluative measures provide a snapshot of performance. For more on this topic see Measure to Evaluate.

From the point of view of marketing behavioral health services, a measure to evaluate strategy can provide a cost effective mechanisim to demonstrate the quality of services. A potential customer can be shown that the organization has previously provided effective services at one point in time (or indicate a track record of performance, if data are displayed over a period of time). Unfortunately, while such data can be used to identify opportunities for improvement, they rarely provide data that can be used to facilitate improvement efforts.

Measure to Improve

A "measure to improve" approach seeks to use data to inform performance improvement efforts. Data can be used in real time to improve the outcome of care and/or allocate resources to maximize value for the health care dollar. Typically, a measure to improve approach relies upon process measures rather than outcome measures, as process measures can quickly identify areas for improvement that can be immediately addressed by the provider or organization. Of course, in order to actually improve patient outcomes and/or add value, the processes being measured must be directly related to a desired outcome. Unfortunately, due to the nature of behavioral health care services (i.e., the importance of finding a fit between therapist, client and treament approach), it is often difficult, if not impossible, to identify processes that are universally linked to outcomes. For more on this topic see Measure to Improve.

Measures associated with an outcomes management approach to measurement use outcome data to inform the treatment process. This provides users with the best of both worlds: outcome data that can be used for evaluative measures and process measures that can be used to improve performance (altering the course of individual treatment while assuring that treatment dollars are used in a manner to maximize benefit to the patient).

-- JebBrown - 2 Dec 2006

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