Outcomes assessment in clinical settings: a consensus statement on principles and best practices in project...

The focus of this article is on health-related outcomes particularly reducing symptoms and improving health status. Public policy, purchaser demand, quality assurance/quality improvement, clinical research, and the computerized medical record have all fed the increasing interest in outcomes. "Outcomes assessment" refers to the measurement, monitoring, and feedback of outcomes. In implementing outcomes assessment, the bulk of the work is concentrated in managing individual projects. From May 1992 through March 1993, under a grant from the Functional Outcomes Program of the New England Medical Center (Boston), the directors of five major health outcomes assessment programs held a series of meetings to share their experiences in implementation. Principles and recommended best practices for project management are provided here. Implementing an outcomes project: Making a commitment to begin includes identifying a condition or procedure to investigate, assembling a project team, and naming a coordinator. Designing a project entails defining its purpose and scope, developing the measurement instruments, and establishing a logistical protocol for data collection. Managing the data entails collecting the data, entering the data into a database, maintaining quality control over the data, and storing the data. Using the data entails analyzing the data, providing feedback and interpretation to clinicians, and linking outcomes to the clinical process.

For a typical outcomes project--total hip replacement--the sequence of activities in the project and the staffing and resources needed are all described.