Basic Concepts of Outcome-Informed Practice (OIP)

OIP Practice in which you: Measure your client’s outcomes at regular, frequent, pre-designated intervals, in a way that is sensitive to and respectful of the client Monitor these outcomes at regular, frequent, pre-designated intervals to determine if your client is making satisfactory progress Modify your intervention plan as needed along the way by using this practice-based evidence, in concert with evidence-based practice, to improve your client’s outcomes

Feedback Ongoing systematic information provided to a practitioner, client, or other person or group regarding a client’s outcomes for the purpose of improving those outcomes

Client Individual, couple, family, group, organization, or community seeking assistance with a problem from a helping professional Also known as a “case,” a “patient” (in medical settings and psychiatric settings) or a “resident (in assisted living facilities, independent living facilities and nursing homes)

Relevant Others Individual who is an important part of another individual’s social network

Helping Professional Social worker, psychologist, psychiatrist, counselor, nurse, physical and occupational therapist, or other allied health care or social service professional

Problem Specific situation, condition, or concern that needs to be addressed in order to achieve a desired goal, including difficulties or deficiencies to be remediated or prevented as well as assets and strengths to be enriched

Goal “If you don’t know where you’re going, you might wind up someplace else.” Yogi Berra

Goal (cont’d) General and abstract statement of a desired outcome for which an intervention is implemented Should indicate change in real-world functioning or quality of life that is sufficient and meaningful to the client, relevant others, and/or society at large

Objective Specific and concrete statement detailing a desired outcome of an intervention along with measurable criteria used to define and evaluate client success

Outcome Measure Tool used to measure the status of a client’s problem along some dimension

Measurement Plan Overall strategy used to measure a client’s outcomes, including the methods and instruments used, as well as how to obtain the information, who can best provide the information, and when, and where, and how often the information should be collected

Progress Monitoring Frequent, regular, systematic measurement and tracking of a client’s outcome(s) in order to determine if the client is making satisfactory progress toward achieving goals

Formative Evaluation Evaluation conducted during the course of a program to provide ongoing feedback used to continuously improve the program while it is underway

Outcomes Management Process of using data about client outcomes to determine the continuation, alteration, or termination of an intervention

Intervention Specific planned action by a helping professional and client, designed to achieve a goal or otherwise bring about beneficial change or prevent an undesirable outcome in a targeted client problem Also referred to as a “treatment” when the intervention is designed to relieve a pathological or otherwise undesirable condition

Intervention Fidelity Extent to which an intervention is implemented as designed and planned Intervention as designed Irrelevant elements - Relevant elements Intervention as implemented

Intervention Monitoring Continual systematic documentation and tracking of the fidelity with which an intervention is implemented in order to ensure that the intervention is implemented with fidelity

Implementation Assessment Evaluation designed to describe and assess the extent to which an intervention is being implemented as originally designed and planned (fidelity) Also known as “process evaluation”

Intervention Adherence Extent to which the client follows a prescribed intervention regimen Also known as “treatment adherence”

Intervention Effect Portion of an outcome change that can be attributed uniquely to an intervention rather than to other influences

Outcome Evaluation Evaluation undertaken to determine the change in client outcomes, if any, resulting from an intervention

Summative Evaluation Evaluation undertaken after an intervention has been completed to examine a program’s ultimate impact in order to determine the extent to which the program was effective in achieving its goals

Intervention Research and OIP Reliable, valid, and sensitive measures are used systematically to quantify and draw conclusions about client outcomes Attention is given to ensuring that the intervention is delivered appropriately although typically these procedures are much more intensive and formalized in intervention research

Intervention Research and OIP (cont’d) Adverse and other side-effects are of concern. Final conclusions are drawn about the extent to which an intervention has had the desired effect

OIP Primary purpose is to improve the well- being of each particular client Tailored to the emerging problems, goals, needs, characteristics, and circumstances of each particular client without regard to the extent to which results will generalize to other clients

Intervention Research Usually initiated to inform practice for future clients through developing generalized causal knowledge about interventions that will contribute to a scientific body of knowledge Benefits to participants are of secondary importance Designs and measures not tailored to individual participants

Intervention Research (cont’d) Focus on the intervention rather than the client Requirements for informed consent for conducting research differ from those in informed consent for conducting treatment

Nomothetic Study of groups of people or cases for the purpose of discovering general principles or laws that characterize the average person or case

Idiographic Study of an individual person or case focused on description and understanding of unique and lawful characteristics, qualities, and responses of that person or case

Single-Case Designs Family of designs characterized by: Systematic repeated measurement of a client’s outcome(s) at regular, frequent, pre-designated intervals under different conditions (baseline and intervention) Evaluation of outcomes over time and under different conditions in order to monitor client progress, identify intervention effects and, more generally, learn when, why, how, and the extent to which client change occurs

Single-Case Design (cont’d) Also known as “single-subject designs,” “single-system designs,” “N = 1 designs,” or sometimes “time series” or “interrupted time series” designs