This book provides up-to-date resources and examples of outcome measures, tools and methods that can be used by APNs in their quest to keep pace with new developments in the rapidly expanding field of outcome measurement. The chapter authors, recognized expert practitioners, offer invaluable insight into the process of conducting outcomes assessments in all APN practice, including the clinical nurse, nurse practitioner, certified registered nurse anesthetist and certified nurse midwife practice specialties. Detailed figures, tables, and examples of outcome studies from actual research in APN practice make this an essential resource for evaluating the true impact the advanced practice nurse has on the delivery and fulfillment of care.
Patient-reported outcomes (PROs) are measures of how patients feel or what they are able to do in the context of their health status; PROs are reports, usually on questionnaires, about a patient's health conditions, health behaviors, or experiences with health care that individuals report directly, without modification of responses by clinicians or others; thus, they directly reflect the voice of the patient. PROs cover domains such as physical health, mental and emotional health, functioning, symptoms and symptom burden, and health behaviors. They are relevant for many activities: helping patients and their clinicians make informed decisions about health care, monitoring the progress of care, setting policies for coverage and reimbursement of health services, improving the quality of health care services, and tracking or reporting on the performance of health care delivery organizations. We address the major methodological issues related to choosing, administering, and using PROs for these purposes, particularly in clinical practice settings. We include a framework for best practices in selecting PROs, focusing on choosing appropriate methods and modes for administering PRO measures to accommodate patients with diverse linguistic, cultural, educational, and functional skills, understanding measures developed through both classic and modern test theory, and addressing complex issues relating to scoring and analyzing PRO data.
This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Rehabilitation Outcome Measures is a comprehensive review and comparison of measurement instruments in rehabilitation. It includes a high-level section on professional practice in physiotherapy and an introduction to the World Health Organisation’s (WHO) International Classification of Health. For those who wish to learn more about the relevance of reported measurement properties, the text focuses on how this knowledge can assist clinical decision-making. Additionally, the book reviews a range of measurements in neurological rehabilitation as well mobility, fatigue, physical activity and patient satisfaction. Rehabilitation Outcome Measures is directed at students preparing for clinical practice, as well as researchers and practitioners seeking information about a range of measurement instruments. Provides details on how to manage a project and select an outcome measure Introduction to WHO’s International Classification of Functioning, Disability and Health Boxes with specific links to clinical decision-making Easy format for review of measurement possibilities in each domain Clear review of 36 measurement instruments
THE COMPLETE PSYCHOTHERAPY TREATMENT PLANNER Of Related interest Arthur E. Jongsma, Jr. and L. Mark Peterson This valuable guide provides a thorough introduction to treatment planning and contains all of the necessary elements for developing formal treatment plans. In an easy-reference, prewritten format, this book presents detailed problem definitions, treatment goals, objectives, therapeutic interventions, and DSM-IVTM diagnoses for over thirty common clinical problems. Practitioners in the field will find this book to be a great time-saver and an invaluable reference. 1995 (0-471-11738-2) 176 pp. THERASCRIBETM FOR WINDOWS(r) The Computerized Assistant to Psychotherapy Treatment Planning. Arthur E. Jongsma, Jr., L. Mark Peterson, and Kenneth Jongsma. This revolutionary computerized treatment planning software lets you create detailed, customized treatment plans easily and quickly. Designed for use in both inpatient and outpatient settings, its user-friendly format allows clinicians to easily access a wide variety of behavioral definitions, treatment goals and objectives, therapeutic interventions, and DSM-IV diagnoses from its huge database. Its well-organized reports are designed to meet the requirements of Medicare, HMOs, and other third-party payers, which makes this program an important tool for evaluating and treating mental illness. 1997 (0-471-18415-2) 4 3.5 disks THE COMPLETE GUIDE TO MANAGED BEHAVIORAL HEALTHCARE Edited by Chris E. Stout and Gerald A. Theis Managed care has radically altered the mental health services landscape. This loose-leaf style reference manual, which is updated semiannually, offers in-depth analysis from leading experts of changes in practice management, quality and outcome issues, technology, and automation. It also addresses important legal, regulatory, fiscal, and contractual concerns. Packed with practical tools and useful sample forms, the Guide includes a comprehensive glossary of managed care terms and a complete list of managed care organizations. 1996 (0-471-12586-5) 324 pp. THE MEASUREMENT & MANAGEMENT OF CLINICAL OUTCOMES IN MENTAL HEALTH Once used almost exclusively by psychotherapy researchers, clinical outcomes testing is quickly becoming a standard component of mental health practice. JCAHO has mandated that outcomes must be included in mental health record keeping by the end of the decade, and the six largest managed care firms have announced plans to begin tracking clinical outcomes. While debates over the potential advantages and disadvantages of this move rage on, the fact remains that all clinicians in managed care systems will soon be compelled to incorporate outcomes assessment into their clinical routines. The Measurement and Management of Clinical Outcomes in Mental Health prepares clinicians and administrators for this inevitability. Written by a team of experts with extensive experience in design and implementation, this timely book explores the rationale behind outcomes measurement and offers readers concrete advice and guidelines on conducting accurate and effective outcomes measurement. In the first half of the book, the authors review the conceptual and practical aspects of outcomes management. Among the issues receiving special attention are: the psychometrics of outcomes; measuring patient satisfaction; implementation strategies; the role of consumer characteristics in outcomes management, especially in regard to needs-based planning; case-mix adjustment strategies; and barriers to implementation and strategies for overcoming them. The second half of the book is devoted entirely to detailed case examples. Over the course of five chapters, the authors vividly illustrate their approaches to outcomes management in five different specialty areas—outpatient psychotherapy, acute psychiatric services, community services, child and adolescent services, and substance-abuse treatment services. The first comprehensive guide to designing and implementing outcomes evaluation systems, The Measurement and Management of Clinical Outcomes in Mental Health is an important resource for all mental health practitioners as well as mental health and managed care administrators.
Test-based psychological assessment has been significantly affected by the health care revolution in the United States during the past two decades. Despite new limitations on psychological services across the board and psychological testing in particular, it continues to offer a rapid and efficient method of identifying problems, planning and monitoring a course of treatment, and assessing the outcomes of interventions. This thoroughly revised and greatly expanded third edition of a classic reference, now three volumes, constitutes an invaluable resource for practitioners who in a managed care era need to focus their testing not on the general goals of personality assessment, symptom identification, and diagnosis so often presented to them as students and trainees, but on specific questions: What course of treatment should this person receive? How is it going? Was it effective? New chapters describe new tests and models and new concerns such as ethical aspects of outcomes assessment. Volume I reviews general issues and recommendations concerning the use of psychological testing for screening for psychological disturbances, planning and monitoring appropriate interventions, and the assessing outcomes, and offers specific guidelines for selecting instruments. It also considers more specific issues such as the analysis of group and individual patient data, the selection and implementation of outcomes instrumentation, and the ethics of gathering and using outcomes data. Volume II discusses psychological measures developed for use with younger children and adolescents that can be used for the purposes outlined in Volume I; Volume III, those developed for use with adults. Drawing on the knowledge and experience of a diverse group of leading experts--test developers, researchers, clinicians and others, the third edition of The Use of Psychological Testing for Treatment Planning and Outcomes Assessment provides vital assistance to all clinicians, and to their trainees and graduate students.
This is an open access title available under the terms of a CC BY-NC 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in field trials'. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. Descriptions of the detailed procedures and methods used in the trials that have been conducted have rarely been published. A consequence of this, individuals planning such trials have few guidelines available and little access to knowledge accumulated previously, other than their own. In this manual, practical issues in trial design and conduct are discussed fully and in sufficient detail, that Field Trials of Health Interventions may be used as a toolbox' by field investigators. It has been compiled by an international group of over 30 authors with direct experience in the design, conduct, and analysis of field trials in low and middle income countries and is based on their accumulated knowledge and experience. Available as an open access book via Oxford Medicine Online, this new edition is a comprehensive revision, incorporating the new developments that have taken place in recent years with respect to trials, including seven new chapters on subjects ranging from trial governance, and preliminary studies to pilot testing.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
