Organize CM outcomes before measuring them

Before you attempt to start measuring case management outcomes, one of the first steps is to organize how you will categorize the data. "In general, there are three classes of outcomes that you can look at from a case management standpoint," explains Patrice L. Spath, ART, BA, president of Brown-Spath & Associates, a health care quality consulting firm based in Forest Grove, OR.

Just as clinical outcomes demonstrate improvements in patient care, case management outcomes demonstrate similar improvements. A patient's reduced length of stay and the payer's reduced costs are just two examples of how case management outcomes demonstrate the effectiveness of your program.

Spath, who recently spoke to case managers at the Hospital Case Management Conference in Atlanta, detailed the following types of outcomes and what case managers should be measuring in each category. The three classes of case management outcomes include the following:

* Physical.

This area includes clinical outcomes, patients' functional abilities, psychological well-being, social functioning, quality of life, and wellness/prevention.

* Service.

Patient satisfaction, timeliness, access issues, and the extent to which families continue to provide care after case management is initiated.

* Financial.

Costs associated with the health care process, the cost of case management functions, hospitalization rates, and nursing home admission rates.

Another step to help you measure case management outcomes is to classify them in the following ranges:

* Immediate: those outcomes emerging during or immediately after a case management intervention.

* Intermediate: those outcomes occurring at the time of completion of an episode of care, which can usually be associated with the case management activities during that episode.

* Long-term: the ultimate outcomes of long-term case management for patients with a particular disease or condition.

"There is a whole range of outcomes that you can pick and choose from, and how broad these outcomes are will vary also," Spath says. *