1. Considering the protocol you are developing: identify the process and outcome indicators associated with the program and briefly describe an approach to measuring each.
Process Measures
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Formative Evaluation - Literature review: Looking at previous studies that are similar for replication purposes but adding a new element. - Review of how things have changed in regards to carrying out the study and who to approach. - Meeting with many different administrators to determine feasibility in regards to which systems can be partners in carrying out the study. |
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Process Indicators |
Means of Verification |
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Narrow down partners and identify stakeholders (system administrators) to participate and schedule conference calls or in-person meetings |
Record who is present at which meetings and keep a running record of who participates on what calls and what objectives were achieved |
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Create Internet based survey for providers in different systems to participate in research protocol. |
Ensure participants are able to be tracked in regards to their responses (survey tool to be identified that can keep participants anonymous but also option for follow-up contact if needed) |
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Follow up with key informant interviews based on survey responses |
Using original survey data to identify and follow-up with key informants. |
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Provide education seminars within hospital systems and clinics centered around benefits of using screening tools. Provide education focused on CMS Medicare guidelines as it relates to depression screenings for OA’s |
Take attendance of who attends the seminars through the use of a sign-in sheet. |
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Encourage PCP staff members to use hospital referral system for follow-up care as needed for patients who screen positive. |
Track the # of times the referral systems is used. With the help of electronic medical records, link patient symptoms (positive for depression) to referral system on the record. |
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Output Indicators |
Means of Verification |
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Use of depression screening tool |
Track through alert in electronic medical record. Providing a status that indicates the screening needs to be cleared (2 times yearly) |
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More referrals |
In electronic record, after screening positive a treatment plan needs to be written specifically around following up with patients who are positive for depression (thinking about the CPRS system used at VA hospitals where patients can be flagged as high risk and providers are required to put in treatment plans) |
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Decrease in mortality |
Data to be tracked over time and obtained through the system
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Decrease in depression symptoms over time |
Patients who screen positive will require more screenings and progress can be tracked via their electronic record over time. |
2. Define one or more “intermediate” outcome measures (reflecting changes in environment, organizational culture, systems of care, patient or public behavior, and/or clinician behaviors) that can inform you about the mechanism by which your intervention achieves its downstream effect on health inform you about the acceptability of your interventionIntermediate Outcome:
- Making Depression Screenings a part of routine practice. This is especially feasible if it’s linked to an electronic medical charting system. In particular, making it an “enabling” practice. If it becomes routine then another intermediate outcome would be using the hospital referral path for providing specialty care for patients who are depressed and potentially suicidal. The debrief can include improvements in the referral process (do providers feel supported by the system in which they practice to refer patients for mental health care?).