using outcomes in the quality improvement process:

Using Outcomes in the Quality Improvement Process:

Setting System Level Standards

Erik R. Stewart, Ph.D. Vice President, System Performance

[email protected]

Renee Kopache, M.S.Recovery Coordinator

[email protected]

History/Purpose of Outcomes

• Ohio Mental Health Outcomes Task Force (OTF) – 1996– Charge

• Develop a statewide approach to measuring consumer outcomes in Ohio’s publicly-supported mental health system

Vital Signs (1998)

• Outcomes Implementation Pilot Coordinating Group– Final recommendations were made in 1999.

Adult Outcomes Domains

• Clinical Status– looks at symptoms that a person may experience

from their illness and how much they interfere with their daily living.

• Quality of Life– examines how “good” a person’s life is, and if their

needs are being met. Also examines how much control a person has over the events in their life (empowerment).

Adult Outcomes Domains

• Functional Status– This domain identifies how well a person is

doing in the community including areas such as work, school and social relationships.

• Safety & Health – Addresses how a person is doing physically

and the amount of freedom they have from psychological harm from self and others.

Adult Outcomes: Instruments

• Adult Consumer Form A

– This form is used by consumers with a severe mental illness. (case management)

– The survey consists of four parts: Quality of Life, Safety and Health, Symptom Distress and Empowerment.


• Adult Provider Form A – consists of two parts: Functional Status and

Safety & Health.

– Provider’s observations and clinical judgments about the consumer’s social & role functioning, housing status, activities of daily living, criminal justice involvement, harmful behavior and victimization.


• Adult Consumer Form B– Consists of three parts: Quality of Life

(excluding empowerment, Safety & Health and Symptom Distress.

– This shorter version of the Adult A form is used for adult outpatient clients. Providers of non-SMD consumers are not required to complete a provider survey.

Youth Outcomes Domains

• Four primary areas or domains of assessment were selected for Ohio Scales:

– Problem severity– Functioning– Hopefulness– Satisfaction with behavioral health

services

Youth Outcomes: Instruments

• Ohio Scales

Three parallel forms: – Y-form is completed by the youth (self-

report for ages 12 and older).

– P-form is completed by the youth’s parent (or primary caretaker).

– W-form is completed by the youth’s agency worker/case manager.

Administration Periods

• Initial• 6 Month• 12 Month• Annually thereafter

(Adult Consumer Form B: Initial and Discharge administrations only)

OCO History in Hamilton County

• Data collection begins – September, 2001• Regular and varied production reporting begins

at same time• Production performance abysmal, though

consistent with other participating areas of State

HCCMHB surveys agencies to discern impediments to production

Agencies React

HCCMHB representatives visit agencies to discern impediments to

production

Impediments (in no particular order):

1) Excuses:

• POV boxes don’t turn on (batteries)• Staff refuse to complete or administer• Multi-million $ agency has only 1 printer• POV box times out too quickly


2) Collection technology:

• POV data system interface with other agency data system(s)


3) Lack of agency/staff “buy-in”

• We know we do good work• We don’t care about consumer outcomes


4) Lack of products/information to staff following administrations (initially)

• Staff frustration with initial software• Introduction of ARROW with use limited to POV• Immediate red flags printout• Weekly reports to staff• Consistent supervisor response to problems• Use of data in “assessment update printout”


5) Diffusion of responsibility (a social phenomenon that

occurs in groups of people when responsibility is not explicitly assigned)

• Request made by QA/Outcomes member to resurrect regular IT/IS staff meetings at HCCMHB. Solicitation made. ONE response.

• Lack of departmental ownership


6) Agency-specific challenges

• Central Point of Access• New administration at agency intake?• Paper and pencil administration• Program support staff enter data

QA Approach Introduced

• Quarterly indicator measuring Initial Adult Provider compliance added to existing indicators

ODMH Introduces Missing Data Reports - Summer, 2003

• Hamilton County Performance– 23% Adult OR/OE– 34% Youth OR/OE

October, 2003 - HCCMHB and Agencies Form PI Sub-committee

to Develop Production Logic

February, 2004 – Ohio Department of Mental Health Presents State

Plan for Upcoming PI Requirements

PDCA Cycle

Plan

Do

Check

Act

April, 2004 – Proposed Logic for OCO Production Measures Shared

With Membership

Initial Adult Consumer Production Analysis


• Claims data compiled for quarter under review

UCI First Svc. Date Min Age UPID Service Type

1000001 7/10/2005 42 10001 CPST

1000001 8/1/2005 42 10002 Counseling

1005002 9/2/2005 28 10001 CPST

2052520 7/20/2005 19 10005 Med Som

2052520 7/25/2005 19 10006 CPST


• “Pre-quarter period” is determined by subtracting 120 days from first date of service in period

UCI First Svc. Date Pre-Quarter Period

1000001 7/10/2005 3/12/2005

1000001 8/1/2005 4/3/2005

1005002 9/2/2005 5/5/2005

2052520 7/20/2005 3/22/2005

2052520 7/25/2005 3/27/2005


• Review of claims during pre-quarter period is conducted. Those exhibiting claims are removed

UCI First Svc. Date Pre-Quarter Period Pre-Quarter Claims

1000001 7/10/2005 3/12/2005 No

1000001 8/1/2005 4/3/2005 No

1005002 9/2/2005 5/5/2005 Yes

2052520 7/20/2005 3/22/2005 No

2052520 7/25/2005 3/27/2005 No


• Unduplicate list by selecting case with highest order service

UCIFirst Svc. Date

Pre-Quarter Period

Min Age UPID

Service Type

1000001 7/10/2005 3/12/2005 42 10001 CPST

1000001 8/1/2005 4/3/2005 42 10002 Counseling

2052520 7/20/2005 3/22/2005 19 10005 Med Som

2052520 7/25/2005 3/27/2005 19 10006 CPST


• Create date range for acceptable OCO administrations

UCI First Svc. Date 1st Svc. Minus 60 1st Svc. Plus 44

1000001 7/10/2005 5/11/2005 8/23/2005

2052520 7/25/2005 5/26/2005 9/7/2005


• Merge Adult Consumer A and Adult Consumer B OCO administrations

• Match by date when acceptable date exists

• Determine production ratio/percentage

January 2005 February 2005 March 2005

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

April 2005 May 2005 June 2005

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Period under review

(4th qtr. FY 2005)

http://www.timeanddate.com/calendar/custom.html?year=2005&month=1&country=1&typ=1&display=1&lang=en&moon=on&hol=86073







Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

1st service in period

May 11, 2005



Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Absence of service determined for 120 day period prior to first service (ensures client is new or in new episode of care)


Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Su Mo Tu We Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Outcome administration expected/sought between March 12 and June 24

HCCMHB OCO Production Performance Improvement Measures

• Initial Measures– Adult Consumer

HCCMHB OCO Production Performance Improvement Measures

• Initial Measures– Adult Consumer– Adult Provider– Youth Consumer– Youth Provider– Youth Parent

• Six-Month Measures– Adult Consumer– Adult Provider– Youth Consumer– Youth Provider– Youth Parent

• 12-Month Measures– Adult Consumer– Adult Provider– Youth Consumer– Youth Provider– Youth Parent

• Long-Term Measures– Adult Consumer– Adult Provider– Youth Consumer– Youth Provider– Youth Parent

June, 2004 – Contract Language Established Obligating Agencies to

70% Compliance on OCO Administrations

July, 2004 – HCCMHB Issues First “Test” Measures

PI Products Provided to Agencies:

UPIDType Number Type

Total Expected

Submitted

Not Submitted

Ratio expectation Ratiocalc

RatioMet

10000 11 Adult Consumer initial 52 43 9 70

82.69230769 yes

10000 12 Adult Provider initial 43 29 14 70

67.44186047 no

10000 13 Child Provider initial 46 39 7 70

84.7826087 yes

10000 14 Child Parent initial 46 40 6 70

86.95652174 yes

10000 15 Child Consumer initial 18 14 4 70

77.77777778 yes

10000 21

Adult Consumer 06 month 20 5 15 70 25 no

10000 22

Adult Provider 6 month 20 4 16 70 20 no

10000 23

Child Provider 6 month 23 18 5 70

78.26086957 yes

10000 24 Child Parent 6 month 23 13 10 70

56.52173913 no

10000 25

Child Consumer 6 month 12 4 8 70

33.33333333 no

10000 31

Adult Consumer 12 month 7 2 5 70

28.57142857 no

10000 32

Adult Provider 12 month 7 3 4 70

42.85714286 no

10000 33

Child Provider 12 month 12 8 4 70

66.66666667 no

10000 34 Child Parent 12 month 12 8 4 70

66.66666667 no

10000 35

Child Consumer 12 month 5 0 5 70 0 no

10000 41

Adult Consumer Annual 274 231 43 70

84.30656934 yes

10000 42 Adult Provider Annual 274 214 60 70

78.10218978 yes

10000 43 Child Provider Annual 62 58 4 70

93.5483871 yes

10000 44 Child Parent Annual 60 57 3 70 95 yes

10000 45

Child Consumer Annual 28 24 4 70

85.71428571 yes

Agency A

31.58%

50.67%

82.76% 83.13%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

FY 05 Qrt1 Initial AdultConsumer




Pe

rce

nt

Co

mp

lete

Spreadsheet containing:

• UCI• First service in period date• Last service in period date• OCO time period parameters• Submission status• Date of administration for submission• Age of client• Service type by numeric rank• Instrument type of submission• Admission date

Agencies may formally dispute findings on a case-specific basis

Measures allow agencies to look closely at specific cases missing administrations to

discern issues

Had to educate agencies on intricacies of logic

Tracking based upon most recent intake date

Had to cut through many “trivial” issues that impacted few clients but served as a distraction from dealing with larger issues (those effecting many expected administrations)

Had to deal with misunderstandings or “loose” understandings of the

administration criteria (ex. Use of “person unable to complete” disposition for unplanned termination/discharges)

Had to move past focusing upon issues related to the logic used in the PI

exercise to focus on agency issues needing attention

Had to manage areas subject to manipulation (ex. Use of “B” consumer administrations when “A” is warranted)

….And in the End…..(Measures of Progress Over Time)

The Heavens Opened!!!!

OCO Production Progress (Outcomes Received/Outcomes Expected)

37.80%

43.00%

51.57%

64.98%

76.60%

86.10%

33.60%

39.60%

47.67%

61.68%

68.44%

76.30%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

4/ 2003-3/ 2004 7/ 2003-6/ 2004 10/ 2003-9/ 2004 1/ 2004-12/ 2004 4/ 2004-3/ 2005 7/ 2004-6/ 2005

Youth Adult

Measures of Progress Relative to Other Board Areas

State Missing Data Report #5 - ADULT Outcomes Received/Outcomes Expected (Oct 1, 2003 - Sep 30, 2004)

17.73%25.52%

47.67%55.28%

70.23%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

State Missing Data Report #6 - ADULT Outcomes Received/Outcomes Expected (Jan 1, 2004 - Dec 31, 2004)

5.50%

73.63%

61.68%59.16%

46.86%

34.52%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

State Missing Data Report #7 - ADULT Outcomes Received/Outcomes Expected(Apr 1, 2004 - Mar 31, 2005)

38.49%

55.80%

56.48%

68.44%

78.51%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

State Missing Data Report #8 - ADULT Outcomes Received/Outcomes Expected (July 1, 2004 - June 30, 2005)

43.2%46.2%

57.6%58.2%

85.8%

76.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

State Missing Data Report #9 - ADULT Outcomes Received/Outcomes Expected (Oct 1, 2004 - Sept 30, 2005)

58.0%

49.7%

63.4%

81.7%

61.2%

85.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

State Missing Data Report #5 - YOUTH Outcomes Received/Outcomes Expected (Oct 1, 2003 - Sep 30, 2004)

10.11%10.24%

38.64%

78.94%

63.11%

51.57%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

State Missing Data Report #6 - YOUTH Outcomes Received/Outcomes Expected (Jan 1, 2004 - Dec 31, 2004)

82.33%

69.58%64.98%

39.51%

30.32%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

State Missing Data Report #7 - YOUTH Outcomes Received/Outcomes Expected (Apr 1, 2004 - Mar 31, 2005)

50.4%

76.6%82.5%

68.9%

42.7%40.1%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

State Missing Data Report #8 - YOUTH Outcomes Received/Outcomes Expected (July 1, 2004 - June 30, 2005)

47.4%

55.0%57.8%

72.5%

84.7%

86.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

State Missing Data Report #9 - Youth Outcomes Received/Outcomes Expected (Oct 1, 2004 - Sept 30, 2005)

69.5%

55.7%

59.9%

75.2%

88.7%89.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

• Additional “learnings”– 120 day absence without new OCO/tx. Plan

update – not clinically sound practice– Delayed tx. Following assessment

Data Use

Ohio Scales Data

Ohio Scales

State Data Report

Youth Consumer Findings

Youth Consumer Problem Severity Scores Statewide (Cross-sectional data)

23.89

18.86 18.68 18.9918.56

18.96 18.9818.37

15

17

19

21

23

25

27

29

31

33

35

Initial 90 Days 180 Days 270 Days 1 Year 2 Years 3 Years 4 Years

Mea

n S

core

Youth Consumer Functioning Scores Statewide (Cross-sectional data)

55.94

58.8759.72

59.5259.4159.3558.75

59.57

40

45

50

55

60

65


Statewide Youth

Youth Parent Findings

Youth Parent Problem Severity Scores Statewide (Cross-sectional data)

28.57

22.15

24.0923.64

22.98

23.1423.12

22.21

15

17

19

21

23

25

27

29

31

33

35


Mea

n S

core

Youth Parent Functioning Scores Statewide (Cross-sectional data)

45

48.29

46.8146.9147.9

48.1648.9549.34

40

45

50

55

60

65


Statewide Youth

Youth Worker Findings

Youth Worker Problem Severity Scores Statewide (Cross-sectional data)

28

21.41 21.43

21.51

21.13

21.14

22.76

21.54

15

17

19

21

23

25

27

29

31

33

35


Mea

n S

core

Youth Worker Functioning Scores Statewide (Cross-sectional data)

43.33

45.8246.66

46.2646.9146.9146.946.87

40

45

50

55

60

65


Does Hamilton County data look like Statewide data?

Youth Consumer Problem Severity Scores Comparison (Cross-sectional data)

23.89

18.86 18.68 18.9918.56

18.96 18.9818.37

15

17

19

21

23

25

27

29

31

33

35


Statewide Youth Hamilton Youth

Youth Consumer Functioning Scores Comparison (Cross-sectional data)

55.94

58.8759.72

59.5259.4159.3558.75

59.57

40

45

50

55

60

65



Youth Parent Problem Severity Scores Comparison(Cross-sectional data)

28.57

22.15

24.0923.64

22.98

23.1423.12

22.21

15

17

19

21

23

25

27

29

31

33

35



Youth Parent Functioning Scores Comparison (Cross-sectional data)

45

48.29

46.81

46.9147.948.16

48.9549.34

40

45

50

55

60

65


Mea

n S

core


Youth Worker Problem Severity Scores Comparison (Cross-sectional data)

28

21.41 21.43

21.51

21.13

21.14

22.76

21.54

15

17

19

21

23

25

27

29

31

33

35


Youth Worker Functioning Scores Comparison(Cross-sectional data)

43.33

45.8246.66

46.2646.9146.9146.946.87

40

45

50

55

60

65


Does a longitudinal design change the picture?

Youth Consumer Problem Severity Scores Over Time

24.26

18.22

17.12

20.09

16.82

18.52

15

17

19

21

23

25

27

29

31

33

35

Initial 6 Month 1 Year 2-4 Years

Group 1 Problem Severity Group 2 Problem Severity Group 3 Problem Severity

F(1,358)=48.747

p=0.000

F(1,327)=16.923

p=0.000 F(1,140)=6.498

p=0.012

Youth Consumer Problem Severity Scores Comparison (Cross-sectional data)

23.89

18.86 18.68 18.9918.56

18.96 18.9818.37

15

17

19

21

23

25

27

29

31

33

35



Youth Consumer Functioning Scores Over Time

58.43

55.96

59.37

57.8

58.84

58.64

40

45

50

55

60

65


Group 1 Functioning Group 2 Functioning Group 3 Functioning

F(1,344)=15.416

p=0.000F(1,319)=1.104

p=NS

F(1,135)=0.018

p=NS

Youth Consumer Functioning Scores Comparison (Cross-sectional data)

55.94

58.8759.72

59.5259.4159.3558.75

59.57

40

45

50

55

60

65



Youth Parent Problem Severity Scores Over Time

30.35

24.89 24.5825.41

27.0526.36

15

17

19

21

23

25

27

29

31

33

35



F(1,1048)=122.748

p=0.000

F(1,689)=10.413

p=0.001

F(1,307)=.679

p=NS

Youth Parent Problem Severity Scores Comparison(Cross-sectional data)

28.57

22.15

24.0923.64

22.98

23.1423.12

22.21

15

17

19

21

23

25

27

29

31

33

35



Youth Parent Functioning Scores Over Time

47.33

42.73

46.88

45.59

45.2146.09

40

45

50

55

60

65



F(1,1014)=75.959

p=0.000

F(1,670)=1.324

p=NS

F(1,294)=.647

p=NS

Youth Parent Functioning Scores Comparison (Cross-sectional data)

45

48.29

46.81

46.9147.948.16

48.9549.34

40

45

50

55

60

65


Mea

n S

co

re


Youth Worker Problem Severity Scores Over Time

28.27

22.3821.8822.97

23.8

22.99

15

17

19

21

23

25

27

29

31

33

35



F(1,1881)=255.721

p=0.000

F(1,369)=1.111

p=NS

F(1,598)=2.251

p=NS

Youth Worker Problem Severity Scores Comparison (Cross-sectional data)

28

21.41 21.43

21.51

21.13

21.14

22.76

21.54

15

17

19

21

23

25

27

29

31

33

35


Youth Worker Functioning Scores Over Time

41.74

44.91

43.9545.04

44.53

45.62

40

45

50

55

60

65



F(1,1810)=152.229

p=0.000

F(1,1132)=8.610

p=0.003

F(1,582)=1.162

p=NS

Youth Worker Functioning Scores Comparison(Cross-sectional data)

43.33

45.8246.66

46.2646.9146.9146.946.87

40

45

50

55

60

65


Does looking at everyone together make sense?

Should the data be apportioned in some manner when considering outcomes?

By Diagnosis?

HCCMHB expenditures for treatment of youth with diagnosis

of 314.01 (AD/HD) from September 2001 (inception of OCO/OYS) to ~ July, 2005 =

$14,470,290 and provided care to 2,652 individuals under the age

of 18.

Youth Ratings - Children With AD/HD (314.01)Change Over Period in Treatment - Problem Severity

24.7

20.99

15

17

19

21

23

25

27

29

31

33

35



F(1,29)=1.49

p=NS

Parent Ratings - Children With AD/HD (314.01)Change Over Period in Treatment - Problem Severity

33.71

26.13

27.3827.18

26.28

24.56

15

17

19

21

23

25

27

29

31

33

35



F(1,178)=25.11

p=.000

F(1,24)=.002

p=NS

F(1,12)=.518

p=NS

Worker Ratings - Children With AD/HD (314.01)Change Over Period in Treatment - Problem Severity

29.01

24.09

21.25

18.59

22.2

22.6

15

17

19

21

23

25

27

29

31

33

35



F(1,324)=61.743

p=000

F(1,61)=.676

p=NS

F(1,45)=2.304

p=NS

Youth Ratings - Children With AD/HD (314.01)Change Over Period in Treatment - Functioning

55.72

58.34

40

45

50

55

60

65



F(1,29)=.747

p=NS

Parent Ratings - Children With AD/HD (314.01)Change Over Period in Treatment - Functioning

41.15

47.79

44.45

45.45

44.54

53

40

45

50

55

60

65



F(1,180)=12.53

p=.001

F(1,23)=1.42

p=NS

F(1,11)=2.62

p=NS

Worker Ratings - Children With AD/HD (314.01)Change Over Period in Treatment - Functioning

40.8

46.76

39.96

44.42

41.54

44.35

40

45

50

55

60

65



F(1,308)=33.810

p=.000F(1,60)=.218

p=NS

F(1,45)=2.298

p=NS

Summary: Findings for all groups (Youth, Parents, & Agency Staff)

indicate that statistically significant gains are made during

the initial period (6 months) of treatment. Findings did not

discern statistically significant differences beyond this point.

Examination of CY 2001 data indicates that of all children with dx.=314.01, 45% receive greater than 180 days of treatment. 25% receive greater than 375 days of treatment. 11% receive greater

than 2 years of treatment.

Considerable disparity exists between agencies in regard to

the average period of treatment for children with this diagnosis.

% of 314.01 (ADHD) Children Receiving Tx. >180 Days by Agency(Agencies serving minimum of 10 ADHD children - CY 2001)

0 0

18.2

27.3

38.540

43.3

52.5

67.471.1

72.7 73.9

100

0

10

20

30

40

50

60

70

80

90

100

G L A C B J H E D F I M K

Ohio Consumer Outcomes Data Mart

http://mhwwwtest.mh.state.oh.us/Screen1/odmhFirstScreen.jsp

Erik R. Stewart, Ph.D. Vice President, System Performance

[email protected]

Renee Kopache, M.S.Recovery Coordinator

[email protected]

using outcomes in the quality improvement process:

Health & Medicine