Outcomes management (Outcome Manag)

Publications in this journal

• Article: Nurses' integration of outcomes assessment data into practice.

  Lisa Cranley, Diane M Doran
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  ABSTRACT: The purpose of this article is to provide initial insight from rational and phenomenologic theoretical perspectives into how nurses integrate baseline and follow-up outcomes assessment data into practice to inform their clinical decision-making. Preliminary findings from 29 nurse interviews indicate that some nurses use outcomes assessment data for evaluating their interventions and for decisions concerning initial and/or discharge planning. Nurses' perceived usefulness of outcomes data was based on task complexity and nurses' level of expertise.
  Outcomes management 8(1):13-8.
• Article: Leading and succeeding in outcomes management.

  Linda D Urden
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  ABSTRACT: An effective OM program offers the best in clinical care, efficiency, and use of organizational resources and results in overall satisfaction for health care consumers, payers, and providers. Although challenges abound in today's health care environment, a strong interdisciplinary team with the appropriate resources and supports and led by a skilled outcomes manager will succeed. Such a team will also develop as other needs and opportunities exist in the future.
  Outcomes management 8(1):2-4.
• Article: Heart failure management across the continuum: a communication link.

  Annette M Walblay
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  ABSTRACT: Patients with heart failure often become lost in the ambulatory healthcare maze on hospital discharge. This causes fragmentation of care due to a lack of a communication link with the ambulatory setting. This article discusses a quality improvement project and addresses the use of a communication tool that helps to transition the plan of care for the heart failure patient from acute care to the ambulatory care setting. The key points focus on the continuance of the plan of care that began during hospitalization and is then extended into the ambulatory setting through care management services.
  Outcomes management 8(1):39-44.
• Article: Hospitalized elders: changes in functional and mental status.

  Joyce J Fitzpatrick, Lori Stier, Ann Eichorn, Yosef D Dlugacz, Linda J O'Connor, Theresa K Salinas, Thomas Smith, Maureen T White
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  ABSTRACT: This article describes outcomes of a new model of care for hospitalized elders and their families. Patient functional and cognitive status on admission and discharge were evaluated for changes as a result of an educational program for preparing family-centered geriatric resource nurses. Patients in the intervention group (n = 173) demonstrated significant improvements in outcome measures (functional and cognitive status) from admission to discharge. A subset (n = 50) was selected from the 173 subjects who comprised the intervention group; this subset was compared with control subjects (n = 44); no statistically significant differences were noted between the 2 groups. Suggestions for future research are presented.
  Outcomes management 8(1):52-6.
• Article: What patient outcome should our outcomes management team measure?

  Gayle R Whitman
  Outcomes management 7(3):94-6.
• Article: How should we select health professionals for studies?

  Rajiv Verma, Douglas A Corley
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  ABSTRACT: The investigation of healthcare professionals' practice patterns has increased sharply, in part driven by the development of practice guidelines; however, the optimal way to select providers is not known. We evaluated three distinct sources of physician specialists for completeness and potential biases. Professional society directories, which are frequently used to identify providers, provided biased populations. A national registry, the American Medical Association master file, produced the most comprehensive, least-biased single source.
  Outcomes management 7(3):129-33.
• Article: Evaluation of the Nursing Outcomes Classification (NOC)--from theory to practice in Israel.

  Yardena Kol, Orit Jacobson, Smadar Wieler, Dorit Weiss, Zipora Sadeh
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  ABSTRACT: A study was undertaken on the use of the Nursing Outcomes Classification (NOC) in different practice settings in Israel that included an analysis of problems that can arise in using NOC and a proposed solution. The results indicated four main problems with using the NOC in nursing practice: It is not possible to build from several indicators a weighted index for estimating patient outcomes; some of the indicators are not identical to the clinical guidelines; the grading scales depend largely on subjective judgment; and we question whether an evaluation scale of 5 grades is necessary for such numerical values as vital signs. We suggest dividing the NOC into three main categories (based on original values, objective values as suggested in the clinical guidelines, and values that require the development of quantitative indices) to enable better implementation.
  Outcomes management 7(3):121-8.
• Article: Outcomes and effectiveness research: capacity building for nurse researchers at the Agency for Healthcare Research and Quality.

  Heddy Hubbard, Patricia Hinton Walker, Carolyn M Clancy, Daniel Stryer
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  ABSTRACT: Several of AHRQ's priority areas including disease prevention, health promotion, primary care, quality of care, service delivery, and patient safety are particularly relevant to nurse researchers. With much national attention focused on nursing-related issues such as staff shortages, training, mandatory overtime, working conditions, and autonomy, it is mandatory that nursing research be conducted to inform healthcare delivery and policy. Nurses also need to contribute to the health services literature so that an even balance of discipline perspective is represented. AHRQ's mandate is represented by the slogan "quality research for quality health care." Although our understanding has expanded of contributors to and determinants of evidence-based practice and the relationship between clinical care and improved outcomes, we have much to learn. Appreciating how and which components of nursing care influence patient outcomes represents an essential area of research in need of development. While clarifying nursing contributions to improved outcomes is not the sole purview of nurse researchers, it is plausible to assume that a clinical background in nursing combined with strong methodological skills can help policy makers and health system leaders understand how nurses can most effectively contribute to outcomes and quality improvement. AHRQ is clearly interested in capacity building of researchers from all relevant disciplines. Nurses, the largest provider of healthcare, need to build capacity and develop a much stronger presence in the health services research community of scholars.
  Outcomes management 6(4):146-51.
• Article: Partnering for congestive heart failure: a clinic without walls.

  Catherine Draus, Annette Walblay, Debra Barraco, Dawn Hall
  Outcomes management 6(1):40-2.
• Article: A balanced scorecard approach for nursing report card development.

  Linda McGillis Hall, Diane Doran, Heather Spence Laschinger, Claire Mallette, Cheryl Pedersen, Linda-Lee O'Brien-Pallas
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  ABSTRACT: In this article we describe the process used to introduce and structure a nursing perspective as part of a balanced scorecard framework within a provincial hospital performance report. Results of a critical literature review and consultative process with key informants are outlined. Nurse-sensitive indicators emerged in the areas of system integration and change, clinical utilization and outcomes, patient satisfaction, and financial performance.
  Outcomes management 7(1):17-22.
• Article: Resource utilization in home health chronic obstructive pulmonary disease management.

  Jan A Steinel, Elizabeth A Madigan
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  ABSTRACT: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in this country, with a total annual cost of approximately $23 billion. This study examined the impact on total resource utilization when a pulmonary specialty team manages the in-home healthcare of the patient suffering from advanced COPD. Following implementation of the pulmonary specialty team, the use of hospital, emergency department, and skilled nursing facility resources decreased while home healthcare resource use increased. The overall costs were reduced on average by more than $13,000 per patient.
  Outcomes management 7(1):23-7.
• Article: Data mining methods for improving birth outcomes prediction.

  Linda K Goodwin, Mary Ann Iannacchione
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  ABSTRACT: Data mining is a research method that is increasingly being used to predict clinical outcomes, for example, cancer or AIDS survival, diagnostic accuracy in abdominal pain or brain tumors, and much more. In clinical practice, predicting which patients will deliver preterm versus full term remains a complex clinical problem for families and the healthcare system. Exploratory data mining was used for predicting birth outcomes in a racially diverse sample (n = 19,970). Duke University provided data (1622 variables) for data mining methods that found 7 demographic variables yielded .72 area under the curve for receiver operating characteristic (ROC) analyses, suggesting that a parsimonious set of preterm birth outcomes predictors may be possible. Improved prediction is needed for interventions to be appropriately targeted for improved birth outcomes management.
  Outcomes management 6(2):80-5.
• Article: SARS infection control in Taiwan: investigation of nurses' professional obligation.

  Huey-Ming Tzeng
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  ABSTRACT: This exploratory, cross-sectional, quantitative study investigated the relationship among hospital nurses' willingness to provide care for severe acute respiratory syndrome (SARS) patients, their attitudes toward SARS infection control measures, and nurses' health status and demographic characteristics. This project was conducted from May 6 to 12, 2003. A total of 126 nurses working in hospitals participated in this study. A conceptual model was developed, and the author designed a questionnaire to test this model. The developed model explained 32% of the variance in nurses' willingness to provide care for SARS patients. Nurses' levels of agreement with general SARS infection control measures, self-treatment of relief of fever and cough, necessity to close Hoping and Jenchi hospitals, nurses' physical health status, and holding a bachelor's degree were statistically significant predictors of nurses' willingness to care for SARS patients. Based on these findings, suggestions and study limitations are discussed.
  Outcomes management 7(4):186-93.
• Article: Symptom status and quality-of-life outcomes of home-based disease management program for heart failure patients.

  Catherine M Todero, Louise M LaFramboise, Lani M Zimmerman
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  ABSTRACT: Symptom occurrence, symptom characteristics (frequency, severity, interference with activities and enjoyment of life), and quality of life were examined in heart failure patients after release from the hospital and 2 months after enrollment in a home-based disease management program. The results provide information on the most common and distressing symptoms in a community-based heart failure population. This information may be useful in guiding assessments and designing specific nursing interventions to include in a home-based disease management program.
  Outcomes management 6(4):161-8.
• Article: Symptom management intervention in elderly coronary artery bypass graft patients.

  Lani Zimmerman, Susan Barnason, Janet Nieveen, Myra Schmaderer
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  ABSTRACT: The purpose of this pilot study was to test the impact of a symptom management intervention (using a device called the Health Buddy) on recovery outcomes (symptom evaluation and response and postoperative problems) of elderly coronary artery bypass graft patients at time of discharge, at 2, 4, and 6 weeks after surgery, and at 6 months after surgery. While there were no statistically significant differences found for many of the study variables, there were trends in the intervention group of more improvement for many of the outcome variables, supporting the need for a randomized clinical trial.
  Outcomes management 8(1):5-12.
• Article: National databases and clinical practice specialist: decreasing postoperative atrial fibrillation following cardiac surgery.

  Linda S Halpin, Scott D Barnett, Nelson A Burton
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  ABSTRACT: In this article, we document how an interdisciplinary committee of health professionals led to an approximate 50% reduction in the incidence of postoperative atrial fibrillation (AF) following a cardiac surgery procedure by using preoperative loading and dosing of PO amiodarone and beta blockade. Patients in this report (n = 3397) included all coronary artery bypass surgery (CABG) and valve replacement/repair procedures from January 1, 2000 to June 30, 2002. The incidence of postoperative AF for a CABG or valve replacement/repair procedure was 19.0% for period A (preprotocol) and 13.5% for period B (postprotocol). This translates into an absolute risk reduction of 5.5% or 113 actual cases of postoperative AF reduced. The role of the clinical practice specialist, a master's prepared nurse, and participation in the national Society of Thoracic Surgeon's database allowed us to track our CABG outcomes, benchmark our outcomes against both national and regional institutions, and make changes in outcomes incidence through performance improvement.
  Outcomes management 8(1):33-8.
• Article: Academic nurse-managed centers: approaches to evaluation.

  Violet H Barkauskas, Joanne Pohl, Lynn Breer, Clare Tanner, Andrea C Bostrom, Ramona Benkert, Susan Vonderheid
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  ABSTRACT: A comprehensive evaluation plan was developed to assess the outcomes of a multiuniversity project to support the development of academic nurse-managed centers (ANMCs). The evaluation included measuring ANMC impact on the clients and communities served, on students, and on the sponsoring faculties and universities. This article includes a discussion of the processes used in evaluation plan development, the variables measured, the tools developed to measure selected variables, and a summary of evaluation findings. Recommendations for use of selected evaluation components across ANMCs are presented.
  Outcomes management 8(1):57-66.
• Article: Blame--do you know it when you see it?

  Patricia Ebright, Kathryn Rapala
  Outcomes management 7(3):91-3.
• Article: Measuring nursing activities using an ecological momentary assessment method.

  Gayle R Whitman, Susan M Sereika, Susan V Dachille
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  ABSTRACT: The ecological momentary assessment method proved to be an effective and efficient method for conducting a study to assess nursing activities across a number of hospital settings and geographic distances. Nurse administrators and outcomes researchers who are seeking to measure and assess nurse activities should consider using this approach.
  Outcomes management 7(2):48-50.
• Article: Outcomes management. A role for everyone.

  Linda D Urden
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  ABSTRACT: In summary, many persons have an impact on the outcomes of care and services, although some are more directly involved in day-to-day clinical care; whereas others are in support roles more removed from the clinical area. To manage outcomes effectively and ensure quality care, key stakeholders must be active participants, and an infrastructure must be in place to support the entire effort.
  Outcomes management 7(2):45-7.