1 Evaluating Outcomes PHAR 841 – PHARMACY PRACTICE MANAGEMENT WEEK 4 HOUR 1 DR. G. MORATAYA, PHARMD, APH Objectives u Describe how using outcome evaluations can improve the value of your service u Discuss why outcomes measurement can lead to success u Evaluate the types of outcomes measurement needed for various scenarios 2 u PhD in Mathematical Physics from Yale, 1929 u Credited with developing the rise of industry in post-war Japan u The Deming Prize was instituted by the Union of Japanese Scientists and Engineers in 1950 Who was W. Edwards Deming? https://deming.org/ 3 Outcome Evaluations of Service u Think of the last time you had a check-up at your dentist u What service did they provide? u Were you satisfied with the experience? u How does the dentist know if you were not satisfied? 4 Location of the office Business hours Handling of insurance claims Friendliness of staff Supplying you with information about your dental care Skill of hygienist and support staff Your treatment options being well explained Skill of your dentist Pain control Cost of services Supplying you with information on new technology and services we provide Typical Dentist Survey Question Types 5 Survey Results u Surveys can generate ratings scales u Ratings scales are usually divided into 2 to 5 categories u 2-scale: No, Yes u 3-scale: Sometimes, Usually, Always u 4-scale: Never, Sometimes, Usually, Always u 5-scale: Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree 6 HCAHPS Surveys u Patients who reported that their nurses "Always" communicated well u Patients who reported that their doctors "Always" communicated well u Patients who reported that their pain was "Always" well controlled u Patients who reported that staff "Always" explained about medicines before giving it to them HCAHPS = Hospital Consumer Assessment of Healthcare Providers and Systems https://www.hcahpsonline.org/globalassets/hcahps/star-ratings/tech-notes/october_2021_starratings_tech-notes_updated.pdf Hospital Compare https://www.medicare.gov/hospitalcompare/profile.html#profTab=1&ID=050138&cmprID=050138&dist=2 5&loc=90004&lat=34.0748887&lng=-118.3082034&cmprDist=2.3&Distn=2.3 7 Survey Method u u The outcomes of surveys are affected by the survey method u Telephone surveys tend to score higher u Written surveys tend to score lower u Surveys done during delivery of service tend to score higher u Surveys done post delivery of service tend to score lower Because the survey method can skew results, the method must be taken into consideration when multiple methods are used. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361249/ 8 Steps u Define the Problem u State the Objectives u Develop a “Framework” u Select Variables to Measure u Identify Confounding Variable u Determine Type of Analysis u Setup Data Collection Tools u Collect Data u Analyze and Assess Data 9 Defining the Problem u The problem should be based on a current outcome u The current outcome should identify the need for improvement u The need for improvement can be based on published outcomes data or on internally-collected data u The problem should not be based on anecdotal information. 10 11 u Create specific objectives that address the problem u Objectives must be measurable u Prioritize the objectives u “Most bang for the buck” Stating the Objectives 12 u Create a plan u Design interventions u Determine the outcomes to be measured u Develop a timeline for implementation, data collection, analysis, and follow-up Establish the “Framework” Selecting Variables u u The ECHO Model u Economic outcomes: Look at costs and benefits u Clinical outcomes: Results of treatment u Humanistic outcomes: Quality of life Look at the consequences of the intervention 13 Identify Confounders u A Confounding Variable is an extraneous variable whose presence affects the variables being studied so that the results you get do not reflect the actual relationship between the variables under investigation. u When conducting an experiment, the basic question that any experimenter is asking is: "How does A affect B?" where A is the probable cause, and B is the effect. Any manipulation of A is expected to result in a change in the effect. http://www.alleydog.com/glossary/definition.php?term=Confo unding%20Variable#ixzz4Jbgdcbf7 14 Pick an Analysis Type u Will you be using surveys? u Will you be evaluating processes? u Other? 15 Setup Data Collection u Surveys will require specific instructions on how to perform them u Processes will require measurements at specific steps 16 Collect Data u Data should be collected over a specified period of time with start and stop dates. u Data should be targeted to the objectives measured. 17 Analyze Data u Check data for consistency u Analyze for errors 18 Assess Data u Compare before and after results u Look for areas that still need improvement u Create a new plan for improvement u Implement and re-assess MR 19 What is an Outcome? u It is the result of study at a certain point in time u It is not an end or even a means to an end u It is part of the process of performance improvement 20 21 https://www.youtube.com/watch?v=edE0Cli943k 22 https://youtu.be/tsF-8u-V4j4 References u Red Bead Experiment: https://youtu.be/ckBfbvOXDvU u If Japan Can Why Can’t We: https://youtu.be/vcG_Pmt_Ny4 u Japanese Union of Scientists and Engineers: https://www.juse.or.jp/deming_en/ u Evaluating Outcome u Richard d’Assalenaux, PharmD 23

Evaluating Outcomes

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