Background
The definition of population-specific outcomes is an essential precondition for the implementation of value-based health care. We developed a minimum standard outcome set for overall adult health (OAH) to facilitate the implementation of value-based health care in tracking, comparing, and improving overall health care outcomes of adults across multiple conditions, which would be of particular relevance for primary care and public health populations.
Methods
The International Consortium for Health Outcomes Measurement (ICHOM) convened an international panel (patients, clinicians, and topic experts). Following the development of a conceptual framework, a modified Delphi method (supported by public consultations) was implemented to identify, in sequence, the relevant domains, the best instruments for measuring them, the timing of measurement, and the relevant adjustment variables.
Findings
Outcomes were identified in relation to overall health status and the domains of physical, mental, and social health. Three instruments covering these domains were identified: PROMIS Scale v1.2—Global Health (10 items), WHO Wellbeing Index (5 items), and the WHO Disability Assessment Schedule 2.0 (12 items). Case-mix variables included a range of sociodemographic and biometric measures. Yearly measurement was proposed for all outcomes and most case-mix variables.
Interpretation
The ICHOM OAH Standard Set has been developed through consensus-based methods based on predefined criteria following high standards for the identification and selection of high-quality measures The involvements of a wide range of stakeholders supports the acceptability of the set, which is readily available for use and feasibility testing in clinical settings.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40271-021-00554-8.
Introduction (comprising background and problem statement):Carers have valuable information that can help the delivery of health care, however, it is often underutilised. There is limited published evidence concerning the effectiveness of carer engagement on patient outcomes. The Clinical Excellence Commission Top 5 Program (the program) is addressing this gap.Short description of practice and context: Patient Based Care (PBC) refers to a model of care focussed on the patients, built on genuine partnerships between Health Care Workers (HCWs) and patients. The program uses up to five personal tips from carers to promote coordination and continuity of care that meets mental and physical health needs for the care recipient, between primary, community and hospital based care.
Description of change implemented:The program enables genuine partnerships between HCWs, carers and care recipients to formally record and share the tips and management strategies. A standardised form enables continuity by staying with the care recipient through all care transition.The program aims to integrate health and social care services by creating awareness of dementia and promoting PBC across all health settings. Following success in the hospital setting, the program is now being integrated into Ambulance, primary, community and homecare settings to ensure care continuity and collaboration.Objective of the change/improvement realised: The program has met its objectives by demonstrating patient and staff experience, clinical outcome and operational benefits. The program has successfully demonstrated an increase in carer satisfaction, enablement of the care recipient to receive personalised care and support as well as HCWs feeling better equipped to meet the unique needs of the person with dementia.
Background: Enabling improved health outcomes and experiences of care for people living with chronic and complex conditions whilst delivering better value care requires a complex co-designed digital approach.
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