Continuous Quality Improvement and Health Care Outcomes Measurement: Implications for Social Work Services

Margaret Dimond, A.C.S.W., Assistant Administrator of the Bone and Joint Center, Henry Ford Hospital

Penny Goldberg, M.S., Assistant Director of Social Work/Discharge Planning, Memorial Sloan Kettering Cancer Center

Traditionally, outcome measures in hospital departments were used only as a quality assurance mechanism. The diversity of each clinical department mandated vastly different outcome guidelines. However, the empirical nature of outcome as opposed to structural or process mechanisms has gained popularity with hospital administration: not only as a beacon of quality, but as a method to allocate resources and determine each department's viability and strength. Thus, social work is placed in an awkward position. How are the complex functions of counseling and discharge planning reduced to a formula by which success can be determined? Furthermore, the formal training given to social work directors for outcome-focused care has been on an ad hoc, and individual basis. Many directors can network and share information to assess the most proficient manner of documenting outcomes, but given the myriad of departmental functions and purpose across the country, it is difficult to reduce the diversity into a common language.

This paper examines outcomes measurement, outcomes in health care, major types of outcomes, and outcomes implications for social work. Two examples of outcome studies are presented using quality assessment and performance improvement methodology. Implications for influencing institutional leadership regarding the role of social work is stressed.

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