Outcome indicators

Important outcome indicators to evaluate postintoxication and/or postwithdrawal treatment of substance abuse and dependence can be divided into three major groups decreased consumption of substances, decreased problems associated with substance use, and increased psychosocial functioning. Although it is less commonly employed, a quality-of-life scale can help determine how substance abuse/dependence treatment has affected your patients lives. If you are involved in the cost-justification of services, a cost-benefit analysis could also become important, although this is more often used at the administrative level,... 

If the matrix can become more graphitic, as the above examples indicate, more shear planes become available hence more microcracking can occur, resulting in greater strain at lower stress levels. Thus the apparent or effective modulus of the 2D composite materials is reduced, and more energy is required to cause failure—an outcome indicated by the difference of area under the as-received and heat-treated load-deflection curves in Figures 7 and 9 ... 

E. 1), the group felt that one outcome (indicated by the dominant color) was most likely, but there is a small chance that another outcome is possible. 

Registries could offer some preliminary information about the distribution and determinants of a few reproductive and developmental outcomes (fetal death, live births, birth defects), but often additional information on exposures and the precise nature of the adverse outcomes will need to be collected. Registry data are simply not available for most fecundity-related outcomes indicative of male and female reproductive health (conception delay, early pregnancy loss). 

Background. Creating measurement indicators is the next step in the CQI process. Measurement of current practices will denote the baseline data for the project. Indicators must be rate based, reporting percent frequency of occurrence over time. The indicator should have a defined data source (utilization records, laboratory records, billing records, etc.), and include a numerator, denominator, reporhng frequency and responsibility, patient population, and threshold goal for improvement. Outcome indicators can be economic, clinical, humanishc, or process measures. Kozma... 

All payers of health care bills are focused on issues of quality and value. Accrediting agencies are following a similar strategy as they look for positive health outcome indicators. The ultimate payer is moving health care providers into an era of assessment and accountability, because too little objective evidence exists that supports a positive correlation between rising costs, quality of care, and optimal health outcomes. 

To evaluate OD impact of clinical RPh on cost and quality of patient care Pharmacokinetic monitoring service None None Physician acceptance, patient outcome indicators, DCA 205 interventions made during 6-mo study 80.9% made to increase quality 18.1% to increase quality and decrease cost ... 

Broadfield, L. Pharmaceutical care in oncology pharmacy practice A method for using outcome indicators. J. Oncol. Pharm. Pract. 1995, 7 (1), 9-14. 

The United States has several major performance measurement systems in place. Two of the most important systems are those directed by the National Committee for Quality Assurance (NCQA) for managed care organization (MCO) accreditation and The Joint Commission on Accreditation in Healthcare Organizations (JCAHO) for health care organization accreditation. Both NCQA s performance measurement system, HEDIS, and JCAHO s IMSystem include several pharmaceutical outcomes indicators. 

Quality is evaluated by measuring relevant indicators. Outcomes indicators (economic, clinical, and humanistic) will be the major importance in the future for clinical pharmacist services. Clinical pharmacist services must relocate themselves strategically as a proactive agent and lead drug therapy in the healthcare team. 

The difference between replicates for all samples (A, B, C D) tested was found to be not significant (p>0.05 NS). ANOVA outcome indicated that the difference between groups for all samples (A, B, C D) tested was not significant (p>0.05 NS). The difference between laboratories when assessed with ANOVA performed on the full dataset (using mean replicate MTC values) of all 4 samples was found to be not significant (p>0.05 NS). 

The challenge with using intermediate consequences of medical interventions lies in finding appropriate interim outcome indicators that can reliably predict the long-term effects of a program or treatment alternative. 

It is further recognized that UlE is a good indicator of iodine intake in a given population, and it has been used as such for many of the studies mentioned in this chapter. UlE is considered the most appropriate outcome indicator for iodine deficiency under field conditions at the district level (Pardede et al., 1998 Andersen, 2001). It is with this background that we set out to determine the iodine intake in pregnant women in the northeast of England. 

A BioAssay summary displays descriptive information and a summary of fhe assay resulfs. This includes an overview and background of what the assay attempts to achieve, the assay protocol utilized, references, definition of all reported assay outcomes, indication of the primary result fields, and explanation of the criteria used when considering samples as active or inactive. One can use the Related BioAssay, Depositor" link to find additional screening performed for a particular assay project. An example bioassay summary is depicted in Figure 12.5. 

An indicator can specify a part of a process to be measured or the outcome of that process. An outcome indicator assesses the results of a process. Examples include the percentage of uncompleted, scheduled IPMs, or the number of uncompleted equipment repairs not completed within 30 days. A process indicator assesses an important and discrete activity that is carried out during the process. An example would be the number of anesthesia machines in which the scheduled IPM failed or the number of equipment repairs awaiting parts that are uncompleted within 30 days. 

Define Indicator. Monitor the productivity of technical personnel, teams, and the department. Productivity is defined as the total number of documented service support hours compared with the total number of hours available. This is a desirable rate-based outcome indicator. Provide feedback to technical staff and hospital administration regarding utilization of available time for department support activities. 

When eomparing outcome indicators related to HSE, it is also important to note differences in how they are defined and reported. For instance, what does reported injuries mean Do they only include injuries leading to absence from work, or all injuries Are serious accidents and fatal accidents included Does lost time injuries mean absence in three days or in more Is reporting voluntary or mandatory ... 

Select outcome indicators that are relevant to the nutrition diagnosis or signs or symptoms, nutrition goals, medical diagnosis, and outcomes and quality management goals... 

Given that short and mid-term outcomes indicate a safe procedure with a few major complications and symptomatic improvement in nearly all patients, one of the most important question is the durability of the procedure in the longer term. Three dis-... 

Outcomes are determined by a combination of the patient s underlying condition and the care they actually receive. Any kind of outcome indicator, such as wound infection is only a very indirect refleaion of the safety and quality of care provided. Comparing units or institutions on such indicators is therefore problematic, as any differences may simply reflect differences in patient populations as well as other factors, such as data quality and random variation. Case mix adjustment, in which rates or mortality or morbidity are statistically adjusted to allow for differences in patient population, is widely used but there will always be some uncertainty about the validity of comparisons based on such data. This is not to suggest that case mix adjustment is not valid or that comparisons should not be made, only to point out that the differences that emerge need thoughtful interpretation (Bottle and Aylin, 2008). 

An example of the outcome indicators (in health sector) that have been developed in recent years are the number of specific surgical operations are made in the country annually, and the level and spread of infectious diseases in the country. 

Outcome indicators are among those typically called lag indicators in safety science literature, as the outcomes always follow something they are the consequences arising from multiple other situational and contextual factors. Outcome indicators measure the outcomes of the socioteehnical system. However, it has to be remembered that safety is not an outcome and thus cannot be measured with outcome indicators. Safety is a dynamic non-event (Weick 1987) and non-events caimot be characterised or counted. Thus, we have to look at the term dynamic and seek to identify the way the non-event is created and acknowledge that we cannot ever capture the non-event itself... 

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