Evaluating models of healthcare delivery using the Model of Care Evaluation Tool (MCET)

Abstract

Background and purpose Our aim was to provide the outcome of a structured Model of Care (MoC) Evaluation Tool (MCET), developed by an FAANP Best‐practices Workgroup, that can be used to guide the evaluation of existing MoCs being considered for use in clinical practice. Multiple MoCs are available, but deciding which model of health care delivery to use can be confusing. This five‐component tool provides a structured assessment approach to model selection and has universal application. Methods A literature review using CINAHL, PubMed, Ovid, and EBSCO was conducted. Conclusions The MCET evaluation process includes five sequential components with a feedback loop from component 5 back to component 3 for reevaluation of any refinements. The components are as follows: (1) Background, (2) Selection of an MoC, (3) Implementation, (4) Evaluation, and (5) Sustainability and Future Refinement. Implications for practice This practical resource considers an evidence‐based approach to use in determining the best model to implement based on need, stakeholder considerations, and feasibility.

What Are Models of Care? A Systematic Search and Narrative Review to Guide Development of Care Models for Premature Ovarian Insufficiency

“…MoC may be systems-level, used to describe organizational infrastructure and delivery of care on a wider scale. 21 An example of this is the hub-and-spoke operational model, whereby an organization consists of a central "hub," with several peripheral "spokes," run by a single-central organization. 22 The Willis-Knighton Health System in Louisiana is an example of this, comprising a central provider with a main campus, and several smaller outreach services, all administered by the one organization, enabling shared resources, personnel, and skills.…”

“…Stakeholder engagement was identified as an essential component of MoCs, 10,16,21,[25][26][27][28][29][30][31][32] underpinning all other key themes and is required at all stages of MoC, from planning to delivery and evaluation (►Fig. 2).…”

“…[42][43][44] Evidence-Based Care MoCs are underpinned by evidence-based practice. 10,16,21,[25][26][27][28][30][31][32] However, MoCs differ from evidence-based guidelines and position statements. Evidencebased guidelines describe what care should be delivered, focusing on the efficacy of specific treatments/investigations and the clinician-consumer interaction.…”

“…Outcomes encompassing clinical care and process delivery, and an evaluation plan, were identified as essential when designing MoCs. 10,16,21,[25][26][27][28][29][30][31][32] The evaluation plan should include the types of outcomes, tools for measuring these, and analytical tests. 16,25,50 The Medical Research Council in the United Kingdom has released guidelines for the evaluation of complex interventions, suggesting a framework for choosing a study design, outcomes, and measures.…”

“…A systematic review of tools to measure process outcomes demonstrated significant heterogeneity between the tools, and these limitations should be considered when selecting measures. 56 Several evaluation frameworks can be applied to capture both clinical and process outcomes for MoC, such as RE-AIM (reach, effectiveness, adoption, implementation, and maintenance), 57 PIPE (penetration, implementation, participation, and effectiveness), 58 and MCET (MoC evaluation tool) 21 ; however, there is no gold standard. A full discussion of different evaluation frameworks is beyond the scope of this review; however, it is suggested that many projects suffer from unreliable or invalid measures, flawed data collection and analysis, and may benefit from dedicated expertise for this.…”