The proposed project, Standardizing Community Care Coordination Measures Linked to Improvements in Quality of Life and Health Outcomes Among Vulnerable Populations, builds on prior performance measurement efforts conducted by the Community Care Coordination Learning Network. Learning Network members purport that performance measures are central to service delivery and quality improvement efforts. However, despite care coordination's growing attention at the national level, research involving the development of measures to assess its effectiveness has not kept pace. Therefore, the goals of this project are to: (1) refine the logic framework for the PathwaysTM Model of community-based care coordination and identify relevant measurement domains for assessing quality and outcomes;(2) draft detailed specifications for selected care coordination quality and outcomes measures. (3) assess the relevance, feasibility, validity and reliability of the measures through a pilot test at nine sites;(4) finalize the measure specifications and develop documentation, data collection and reporting tools to facilitate their use. The project uses a community-based participatory research approach to measure design and testing that will draw on the knowledge and experience of the care coordination leadership and specialists at nine participating community sites, as well as an Expert Panel. Key steps in our approach include refining a care coordination logic model that captures the core functions of the Pathways Model-enrollment, identification, and reduction of barriers to care;confirming the delivery of evidence-based care;and documenting outcomes. In collaboration with our care coordination partners and experts, the project team will draft detailed measure specifications and conduct an empirical test of the measures and measurement process at participating sites. We will accomplish this task by collecting needed measurement data and meta-data (i.e., data for evaluation and refinement of measure definitions). The test data will allow us to assess the feasibility and validity of the measures and the data sources, as well as their ability to distinguish between higher and lower quality care coordination. Finally, we will work collaboratively with the sites to develop a performance feedback plan via an electronic interface that will support a variety of comparative performance data displays for at various levels of comparison and detail. Of scientific importance will be the development of crosscutting measures that are applicable for use with various types of health conditions, processes of care, and outcomes. Additionally, they will also be designed for use across a range of populations and care coordination organizational designs. This project will create new and newly validated measures for assessing the impact of community-based care coordination on health and well-being, as well as begin to build an evidence base. The participating study sites coordinate care for primarily unserved and/or underserved populations. Therefore the proposed project supports current health reform and DHHS efforts to reduce health disparities by improving health outcomes for at-risk populations.
This project will create new and newly validated measures for assessing the impact of community-based care coordination on health and well-being, as well as begin to build an evidence base. The participating study sites coordinate care for primarily unserved and/or underserved populations. Therefore the proposed project supports current health reform and DHHS efforts to reduce health disparities by improving health outcomes for at-risk populations.
