WHAT FOLLOWS BELOW IS AN EXAMPLE OF AN OUTCOME EVALUATION THIS WAS AN EXPERIMENTAL “CLINICAL CASE MANAGEMENT PROGRAM” RUN IN COLLABORATION WITH THE DEPT. OF HUMAN RESOURCES AND THE DEPT. OF COMMUNITY AFFAIRS (HOUSING). The goal of this particular “Clinical Case management Program” was to help people with chronic and severe psychiatric diagnoses to ‘live successfully and independently within the community’. Research questions were : 1. How effective is out program in meeting objectives one through five (did the program make a difference question – see last weeks notes)? 2. Which services contributed most to program effectiveness (association or connection question). Program Objectives were.1. to reduce the number of unplanned disruptions to independent living. 2. To reduce ‘breaks’ in independent living. 3. to reduce the need for unplanned and/or emergency services. 4. to reduce the need for changes to or interventions in housing situation. 5. to reduce the number of critical incidents in people’s lives. 6. to provide services that would be effective in helping clients live independently. Because the objectives were measurable and the questions involved the effectiveness of the program, the evaluation was summative – an outcome evaluation!!!!
IN ORDER TO ANSWER EACH RESEARCH QUESTION, THE PROGRAM OBJECTIVES NEEDED TO BE OPERATIONALIZED! THIS WAS DONE BY CREATING OUTCOME MEASURES FOR EACH OBJECTIVE! BECAUSE THE PRGRAM OBJECTIVES WERE VERY SPECIFIC, IT WAS EASY! Outcomes measures for program objective – one through 5 -were: #1 scores on the use of crisis intervention services #2 number of e.r. visits. #3. Number of days in hospital, number of hospitalization, alternative housing or respite care. #4. number of housing interventions or housing changes #5 number of total critical incidents .
This was a pilot program • If successful, it would lead to more programs like it. • On the next slide is the Program Logic Model that was “developed” for the program model. • Ultimately it was not used.
Note that the PLM can ‘capture’ all aspects of the Program that planners and staff wanted
The next slide shows part of the form that was filled out monthly on each client in the program – is designed to measure the ‘operationalized outcomes’. (in outcomes column # 1 thru 7 on PLM) • It was the first part of a larger form
The second question - which services were most helpful - was more difficult! 6. to provide services that would be effective in helping clients live independently. HERE IS HOW IT WAS OPERATIONALIZED AS AN OUTCOME MEASURE #6 correlations between the use of certain services listed on the form above (in bold black) and the variables listed on the form above in bold red. BECAUSE IT IS A QUESTION ABOUT ASSOCIATION (CONNECTIONS), WE HAD TO LOOK AT CORRELATIONS (CONNECTIONS)!!! In order to answer the question, “Which services contributed most to program effectiveness?” we had to look at two ‘sets’ of variables 1. THE FIRST FIVE OBJECTIVES OPERATIONALIZED BY THEIR OUTCOME MEASURES AND 2. THE USAGE FOR EACH SERVICE/INTERVENTION COMPONENT OF THE PROGRAM. Again I sat down with the service providers from two different agencies. At first they did not think they provided the same services. The more we talked, it became clear that they did MANY of the same things, they just called them different things. So what we did was to develop the second part of the instrument and take MONTHLY LOGS of the services provided (the likert scales on the form above measures usage of service in FREQUENCY AND INTENSITY (IN BOLD BLACK ON THE FORM BELOW) AND SEE WHICH SERVICES CORRELATED THE MOST WITH A DECREASE IN THE ITEMS IN BOLD RED ( # OF HOSPITALIZATIONS, HOUSING COMPLAINTS, HOUSING INTERVENTION, CRITICAL INCIDENTS ETC)
Finally, you might be evaluating a program like “ adult outpatient services in mental health”. • In a program like this, all of the clients are working on individual issues or objectives • The program objective then is “to help each client to achieve their individual objectives” • Because you have “individualized outcomes”, you need some way to “translate” these individual outcomes into some “programmatic measurement” • We will cover that next week. See chapter 7 in your text