Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal
JournalBMC Health Services Research
PublisherBioMed Central Ltd.
MetadataShow full item record
AbstractBackground: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families. Methods: An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi process, were held to reach consensus on the proposed Standard Set. Results: The Working Group selected 24 outcome measures to evaluate care during pregnancy and up to 6 months postpartum. These include clinical outcomes such as maternal and neonatal mortality and morbidity, stillbirth, preterm birth, birth injury and patient-reported outcome measures (PROMs) that assess health-related quality of life (HRQoL), mental health, mother-infant bonding, confidence and success with breastfeeding, incontinence, and satisfaction with care and birth experience. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were also defined. Conclusions: We propose a set of outcome measures for evaluating the care that women and infants receive during pregnancy and the postpartum period. While validation and refinement via pilot implementation projects are needed, we view this as an important initial step towards value-based improvements in care. Copyright 2018 The Author(s).
SponsorsThis work was supported by the generous donations of the HCF Research Foundation, SA Health, Karolinska University Hospital, and Hoag Hospital.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85058346191&doi=10.1186%2fs12913-018-3732-3&partnerID=40&md5=f9e48000d819da3a3376ed114b323f6b; http://hdl.handle.net/10713/9756
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Lessons learned from EAPs using the Workplace Outcome Suite for counseling: Part 3 of Series with global data from the Workplace Outcome Suite© by Morneau ShepellAttridge, Mark; Sharar, David A., 1961-; Veder, Barb; Steenstra, Ivan (Employee Assistance Society of North America, 2020-06)This is the final paper in a three-part series based on the Workplace Outcome Suite© (WOS) Annual Report for 2018.1 The WOS is a scientifically validated tool that is offered free to the employee assistance field. This paper profiles 11 employee assistance programs (EAPs) that collected WOS data for counseling cases and two EAPs that collected WOS data for special projects. This sample of EAPs was engaged to represent programs from both the U.S. and other countries. The EAPs ranged in size and delivery model (i.e., external vendor, internal staff, or hybrid of some staff combined with a vendor). The study used a survey to address a variety of questions related to data collection methods, reporting practices, and customer reactions to the results. Best practice recommendations for data collection using the WOS-5 are also identified.
Measuring Outcomes and Mitigating Risk with the Workplace Outcome Suite in the Federal WorkplaceTamburo, Melissa Back; Mintzer, Jeffrey (2017-05-12)Federal Occupational Health (FOH) is the largest provider of occupational health services in the Federal Government, serving more than 360 federal agencies and reaching 1.8 million federal employees. FOH began providing Employee Assistance Program (EAP) services in 1980, and is Health and Human Services’ recognized expert in this key area of employee health programs, delivering specialized EAP services exclusively to over 905,624 federal employees. More than ten years ago, we integrated our EAP with our WorkLife program and many of the Agencies we serve are accustomed to our integrated set of resources. FOH has a rich history of working to advance the knowledge of the EAP field, and was an early supporter of measuring program outcomes. Selvick, Stephenson, Plaza and Sugden (2004) published one of the few studies that demonstrate statistically and practically signifcant outcomes from the FOH EAP. Their work showed significant improvement from pre- to post- EAP intervention on measures of productivity; work and social relationships; perceived health status; attendance and tardiness; and global assessment of functioning. In an effort to revitalize the findings with more current outcomes, FOH engaged an industry gold-standard tool, the Workplace Outcome Suite (WOS). A 5-item measure, this tool is psychometrically tested and easy to administer telephonically during the intake proces. It consists of 5 scales that measure absenteeism, presenteeism, work engagement, life satisfaction, and workplace distress, In October of 2015 FOH began to collect data on specific outcomes for clients who accessed the EAP.
Risk Management Approach to Analyzing Outcomes from EAP Counseling: Part 1 of Series with Global Data from the Workplace Outcome Suite© by Morneau ShepellAttridge, Mark; Sharar, David A., 1961-; Veder, Barb; Steenstra, Ivan (Employee Assistance Society of North America, 2020-01)This is the first paper in a three-part series based on the Workplace Outcome Suite© (WOS) Annual Report for 2018.1 This self-report measurement tool was developed by Chestnut Global Partners in 2010 and is now owned by Morneau Shepell. It is a scientifically validated tool offered free to the employee assistance field. In this paper, we advance a risk management approach to understanding how employee assistance program (EAP) services can be used to greater advantage by employers. This approach uses an alternative procedure for coding the WOS data and for analyzing the results for change over time. This method asks, for each WOS outcome area, how many employees (as a percentage of all EAP cases) are at a problem level on the outcome when first seeking counseling and also at the follow-up? The difference in these two percentages indicates how many cases had improved after counseling to no longer have a “problem” with missing work, or with work engagement, and so on. Self-report data was collected at the start of counseling and at 60-90 days after counseling ended. The sample was 24,363 cases worldwide from multiple EAPs with data collected between years 2010 to 2018. Results found that after deducting the small percentage of cases who changed from no problem at the start to having a problem after use, the net change in rates among EAP users of having a problem in each outcome was significantly reduced: work presenteeism with 56% of cases with problem at before vs. 28% after; life satisfaction with 38% of cases with problem at before to 21% after; work absenteeism with 34% of cases with problem at before vs. 20% after; work engagement with 31% of cases with problem at before vs. 10% after; and workplace distress with 22% of cases with problem at before vs. 9% after. When adding up problem status (yes or no) within person for all five WOS measures (range from 0 to 5 at each time point), the average number of outcome areas with a problem was significantly reduced from 1.81 per case at before to 0.94 at after use. These findings demonstrate that brief counseling was effective at reducing work-related problems of users, even when most employees (82%) had used the EAP for issues other than work. This study shows how a behavioral health risk management approach can be successfully applied to interpreting and reporting on work-related outcomes from EAP counseling.