To date, most health services and clinical outcomes research has focused on broad contextual variables such as size, ownership, or professional credentialing, and on treatment during a single episode of care. There is a significant need for outcome indicators that can be used to measure outcomes of longer-term care. We therefore propose an invitational, state- of-the-science conference with 30 participants from the nursing and health services research community. This conference, scheduled for spring of 1996, will have three goals: * to identify and further develop patient care outcome measures sensitive to organizational variables in clinical care delivery systems; * to recommend research priorities for outcome indicator development sensitive to the effects of care delivery system to the Agency for Health Care Policy and Research (AHCPR), the National Institute of Nursing Research (NINR), and relevant health services and nursing care systems organizations; and * to disseminate the findings regarding measures sensitive to care delivery by publishing a monograph of working papers presented at the meeting directed to health services researchers, clinical researchers and nursing and health care administrators. Nurse investigators will be paired with experts in health services research to develop working papers on: l) standard measures of outcomes, such as morbidity/mortality outcomes over time; 2) health-related quality of life (HRQOL); 3) symptom management to criterion; 4) achievement of appropriate self-care; 5) patient perception of being well cared for; 6) demonstration of health-promoting behaviors; and 7) methodological issues in linking organizational variables and outcomes research. The conference will be devoted to the presentation of these working papers and discussion by all participants of strategies for measurement, available data sets, strengths and weaknesses of different methodologies, recommendations for further measurement development, and policy issues. The American Academy of Nursing and other co-sponsoring organizations will disseminate the recommendations to state and national health care organizations and research groups, and will assist the authors in disseminating their work to health services research and administration journals. This conference will result in a much stronger base of knowledge about outcomes across settings and better standards by which to evaluate the quality of care systems over time.
