Sponsored by the Center for the Study of Social Work Practice. The Center for the Study of Social Work Practice is a joint program of the Columbia University School of Social Work and the Jewish Board of Family and Children's Services. Supported by gifts from the Virginia and Leonard Marx Foundation, David S. Lindau and the Beatman Foundation
Program
November 9 and 10, 1995
Faculty House and Kellogg Conference Center at Columbia University
Description: This symposium was convened because of the importance of carefully considering the issues associated with outcomes measurement as the nation engages in a re-examination of the purposes of social interventions and desired outcomes. National debates regarding health and welfare reform have and will continue to focus attention on outcomes - both intended and unintended. For the research community there is particular need to add to this discussion by addressing the tough issues of outcomes measurement. Outcomes measurement requirements are already reshaping the nature of social work practice, social agency programs, and organized service systems. This reshaping will continue during the next decade.
While the topic of outcomes measurement has been and will continue to be extensively discussed in many forums the issues have particular relevance to the social work profession which is a core group providing social services. The symposium brought together over 200 social welfare and social work professionals concerned with outcomes measurement representing policy, administration, practice and research perspectives.
The symposium examined the following questions:
How can outcomes measurement be usefully reconceptualized, and placed in historical, public policy, administration, practice and research contexts?
What is the legislative and public policy context of outcomes measurement - why is there a need to address outcomes in a measurable way?
What approaches to outcomes measurement are being promulgated? - a descriptive and critical analysis.
What can be said about the reliability, validity and quality of existing approaches to outcomes measurement and their relevance for social work interventions?
What are the implications for social programs and for practitioners of the increasing attention to outcomes measurement?
What are the implications for future research?
While outcomes measurement is a broad topic the symposium focused on how this topic is being redefined in the context of public policy. Social work has long been concerned in its research with evaluation of effectiveness. More recently the managed care context has pushed the profession toward thinking of outcomes measurement as an integral part of service delivery. The symposium provides the profession with an opportunity to rethink outcomes measurement in this new context. While the focus is on implications for social work, the expertise pertaining to this topic is necessarily interdisciplinary. Accordingly, presentations were made by experts drawn from relevant professions and disciplines.
The symposium was held at Columbia University's Kellogg Conference Center and the Faculty House. It extended over one and a half days, and included an evening reception at Low Memorial Library.
The proceedings are being prepared as a book to be published in the first quarter of 1997 (Mullen, E.J. and Magnabosco, J., Eds., in press. Outcomes Measurement in the Human Services, Washington, D.C.: National Association of Social Workers Press).
PROGRAM
November 9, 11:30 A.M. to 5 P.M. Faculty House
A. Welcome and Introductions
11:30 - 12 P.M.
Edward J. Mullen, D.S.W., Director, Center for the Study of Social Work Practice and Willma and Albert Musher Professor, CUSSW
Alan B. Siskind, Ph.D., Executive Vice-President, JBFCS
Ronald A. Feldman, Ph.D., Dean, CUSSW
B. Outcomes Measurement: Program Outcomes - Conceptual and Measurement Issues
12 - 1 P.M. (lunch)
Chair: Irwin Garfinkel, Ph.D., Mitchell I. Ginsberg Professor of Contemporary Urban Problems, CUSSW
Dr. Rossi presents a reconceptualization of outcomes measurement in the current context of evaluation research, managed care and cost-containment.
Peter Rossi, Ph.D., Stuart A. Rice Professor Emeritus, Director Emeritus, Social and Demographic Research Institute, University of Massachusetts at Amherst
C. Outcomes Measurement: Health Care Outcomes from the Patient Point of View
1 - 2 P.M.
Chair: Bruce A. Grellong, Ph.D., Chief Psychologist and Director, Martha K. Selig Educational Institute, JBFCS
Dr. Ware presents outcomes measurement in the context of managed care with specific reference to functional assessment in health and behavioral health.
John E. Ware, Jr., Ph.D., The Health Institute, New England Medical Center
Coffee Break
2 - 2:15 P.M.
D. Outcomes Measurement and Social Services: The Governmental Perspective
2:15 - 3 P.M.
Chair: Lawrence Martin, Ph.D., Associate Professor, CUSSW
Mr. Hatry discusses current and projected outcomes measurement of social services at the federal, state and local government levels.
Harry Hatry, Director of State and Local Government Programs, The Urban Institute
E. Outcomes Measurement under Managed Care
3 - 4 P.M.
Chair: George Nashak, Director, Quality Management and Program Evaluation, JBFCS
Dr. Manderscheid discusses current and projected outcomes measurement in the area of behavioral health including substance abuse and mental health.
Ronald Manderscheid, Ph.D., Branch Chief, Survey and Analysis Branch, Division of State and Community Systems Development, Center for Mental Health Services, NIMH
F. Outcomes Measurement: Evaluating Family Programs
4:00 - 5 P.M.
Chair: Brenda McGowan, D.S.W., Professor, CUSSW
Dr. Weiss discusses outcomes measurement from the perspective of evaluating family programs.
Heather B. Weiss, Ed.D., Director, Harvard Family Research Center, Harvard University
H. Reception
Hosted by David and Josie Lindau at Columbia University Low Library Rotunda 6:00 - 8:00 P.M.
November 10, 8 A. M. to 5 P.M. Schpiro Center for Engineering and Physical Science Research Davis Auditorium, the Kellogg Conference Center and Intenational Affairs Building
A. Coffee
8 AM - 8:30 AM
B. Outcome Measurement: The State of the Science
8:30 - 9:30 A.M.
Chair: Rami Mosseri, Ph.D., Director, Residential Treatment Facilities, JBFCS
Dr. Brenda Booth, Ph.D. provides an overview of the state of the science of outcome assessment including a specification of the objectives of outcome assessment, areas of success to date, current issues of scientific debate, the areas of present and future challenges for the field, and recommendations for advancing the field.
Brenda M. Booth, Ph.D., Associate Professor, The Center for Outcomes Research and Effectiveness, National Institute of Mental Health Center for Rural Mental Healthcare Research and Department of Veteran's Affairs Health Services Research and Development Field Program for Mental Health, Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
Questions and Comments from Participants to Panel
9:30 - 10:30 A.M.
Symposium participants present questions to Mr. Hatry and Drs. Booth, Manderscheid, Rossi and Weiss.
10:45 A.M. - 3:30 P.M. (with lunch)
The concurrent sessions provide for in-depth consideration of specialized topics. One session examines outcomes measurement systems currently in use with presentations of five major approaches to measurement and information systems. Three additional sessions consider outcomes measurement in each of three fields: (1) health; (2) mental health/behavioral health; (3) family and child welfare. Each includes one or two presentations by experts in the area addressing the particular issues associated with outcomes measurement in that field. Common questions for consideration include those listed above.
1. Outcomes Measurement Systems Currently In Use
This session is a panel presentation of major outcomes measurement systems currently used in health, mental health/behavioral health, family-child welfare, and clinical services.
Chair: Rami Mosseri, Ph.D., Director, Residential Treatment Facilities, JBFCS
Kathryn M. Rost, M.S.W., Ph.D., Associate Professor, The Center for Outcomes Research and Effectiveness, National Institute of Mental Health Center for Rural Mental Healthcare Research and Department of Veteran's Affairs Health Services Research and Development Field Program for Mental Health, Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
10:45 - 11:25 A.M.
RAND Outcomes Measurement Programs
Ian Coulter, Ph.D., Health Consultant, RAND Corporation, Santa Monica, CA; Director, Minority Oral Health Research Center, University of California at Los Angeles.
11:25 - 12:20 P.M. (with lunch)
PRIME-MD - developed with Robert Spitzer, M.D.
Janet B.W. Williams, D.S.W., Professor of Clinical Psychiatric Social Work, Department of Psychiatry, College of Physicians and Surgeons, Columbia University
12:20 - 1:00 P.M.
Original Programming
William H. Berman, Ph.D., President,
and Stephen W. Hurt, Ph.D.,
Behavioral Health Outcomes Systems (BHOS, Inc.)
1:00 - 1:40 P.M.
Integrated Information System for Foster Care - IIS-FC
Rami Benbenishty, Ph.D., Professor, Paul Baerwald School of Social Work, Hebrew University of Jerusalem and, Professor, The Merrill-Palmer Institute for Family and Human Development, Wayne State University
1:40 - 2:20 P.M.
Clinical Measurement Package - CMP
Walter W. Hudson, Ph.D., Professor, School of Social Work, Arizona State University
2:20 - 3:00 P.M.
Discussion
3:00 - 3:30 P.M.
2. Outcomes Measurement in Health
Co-Chairs: Rita Black, Ph.D., Associate Professor, CUSSW;
Grace Christ, D.S.W., Associate Professor, CUSSW
Outcomes Measurement for Social Work Research and Practice in Health Care
Barbara Berkman, D.S.W., Director of Social Work Research and Quality Assessment, Massachusetts General VIEW BIOGRAPHICAL SKETCH
10:45 - 11:15 A.M.
Three Community Based Outcomes Measurement Studies
a. An Application of the Use of Outcomes Measurement with Multiply Diagnosed Low Income Ethically Diverse Clients
Rosemary Moynihan, M.S., Coordinator, Mental Health Program Comprehensive Care Center for HIV, St. Joseph's Hospital and Medical Center
Marjorie Royle, Ph.D., Coordinator of Research and Evaluation, Department of Psychiatry, St. Joseph's Hospital and Medical Center
11:15 - 11:35 A.M.
b. A University - Based Breast Cancer Program Support Service: Process and Outcomes
Sherrie Gorin, Ph.D., Associate Professor of Social Work, Adelphi School of Social Work
Barbara Balaban, A.S.C.W., Director of Adelphi New York Statewide Breast Cancer Hotline and Support Program
11:35 - 11:55 A.M.
c. A VA Hospital Intensive Case Managed Community Residential Care Program for Discharged Severely Mentally Ill Patients: Objectives and Outcomes
David Gitelson, D.S.W., Chief, Social Work Service, FDR VA Hospital
Arthur Russo, M.S.W., Program Director of Intensive Psychiatric Community Care, FDR VA Hospital
11:55 - 12:15 P.M.
Using Available Information in Practice-Based Outcomes Research: A Case Study of Psycho-Social Risk Factors and Liver Transplant Outcomes
Irwin Epstein, Ph.D., Helen Rehr Professor of Social Work Research in Health Care, Hunter College School of Social Work, City University of New York
Felice Zilberfein,Ph.D., Preceptor, Department of Social Work Service, Mt. Sinai Hospital
12:15- 2:00 P.M. (with lunch and open discussion moderated by Drs. Black and Christ)
Three Outcomes Measurement Studies
a. Hospital Discharge Planning: A Comparative Analysis of Two Social Work Models Serving AIDS Patients
Marianne C. Fahs, Ph.D., M.P.H., Associate Professor and Director of Health Economics, Mt. Sinai Medical Center
Kathy Wade, M.S.W., Assistant Director of Social Work Services at Columbia Presbyterian Medical Center
2:00 - 2:20 P.M.
b. Prospective Psychosocial Interventions: A Merger of Clinical and Research Techniques
James R.. Zabora, M.S.W., Director, Patient and Family Services, Johns Hopkins Oncology Center
2:20 - 2:40 P.M.
c. Outcomes Measurement Through Performance Management: Theory and Applications
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
2:40 - 3:10 P.M.
Open Discussion: An Agenda for the Future
Participants 3:10 - 3:30 P.M.
Outcomes Measurement in Mental Health/Behavioral Health
Co-Chairs: Andre,Ivanoff, Ph.D., Associate Professor, CUSSW and Robert Abramovitz, M.D., Chief Psychiatrist, JBFCS
Rapporteur: Anne O'Sullivan, M.P.H.
Comments on Outcomes Measurement Systems in Mental Health: Comparisons and Contrasts
Kenneth Howard, Ph.D., Professor, Department of Psychology, Northwestern University, and Chief Scientific Advisor, COMPASS, Inc.
10:45 - 11:15 A.M.
The Use of Rapid Assessment Instruments as Outcomes Tools
Kevin Corcoran, Ph.D., Professor, School of Social Work, Portland State University
11:15 - 11:45 A.M.
Commentary and Discussion of Presentations
Paula S. Nurius, Ph.D., Professor, School of Social Work, University of Washington
Betsy Vourlekis, Ph.D., Associate Professor, Department of Social Work, University of Maryland
11:45 - 12:15 P.M.
Three Breakout Workshops on Levels of Outcomes Measurement: (1) System-Policy Level; (2) Program Level; (3) Client Level
System-Policy Level:
Facilitator: Ronald Manderscheid, Ph.D., Branch Chief, Survey and Analysis Branch, Division of State and
Resource Experts:
Tom Trabin, Ph.D., Vice-President, Informatics and Outcomes Initiatives, CENTRALINK
David Shern, Ph.D., Dean and Director, Florida Mental Health Institute, University of South Florida
Program Level:
Facilitator: Marjorie Rock, Ph.D., Associate Professor, Wurzweiler School of Social Work, Yeshiva University
Resource Expert:
Steven Segal, Ph.D., Professor and Director of Mental Health Research Group, School of Social Welfare, University of California at Berkeley
Client Level:
Facilitator: John Kastan, Ph.D., Executive Director, New York Continuum, Continuum Behavioral Healthcare Corporation
Resource Expert:
Mona Wasow, Ph.D.,National Alliance for the Mentally Ill (NAMI); Professor, School of Social Work,University of Wisconsin at Madison
12:15 - 1:45 P.M.
Breakout Session Reports by Facilitators
2:00 - 2:30 P.M.
Open Discussion with Panel of Presenters and Resource Experts
2:30 - 3:30 P.M.
Outcomes Measurement in Family and Child Welfare
Co-Chairs: Brenda McGowan, D.S.W., Professor, CUSSW and Steven D. Cohen, M.P.A., JBFCS
Introductions and Overview of Issues in Outcomes Measurement in Family and Child Welfare
Brenda McGowan, D.S.W., Professor, Columbia University School of Social Work 10:45 - 11:30 A.M. (with discussion)
Methodological Considerations in Outcomes Measurement in Family and Child Welfare
Fred H. Wulczyn, Ph.D., Assistant Professor, Columbia University School of Social Work and New York State Department of Social Services
11:30 - 12: P.M.
Three Breakout Workshops on Levels of Outcomes Measurement: (1) System-Policy Level; (2) Program Level; (3) Client Level
System-Policy Level
Facilitator: Carol H. Meyer, D.S.W., Ruth Harris Ottman Professor of Family and Child Welfare, CUSSW
Resource Expert:
Matt Stagner, Ph.D. Senior Policy Analyst, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
Program Level
Facilitator: Martha Dore, Ph.D., Associate Professor, CUSSW
Resource Expert:
Jacquelyn McCroskey, Associate Professor, School of Social Work, University of Southern California
Client Level
Facilitator : Annaclare van Dalen, Ph.D., Administrative Supervior and Director of Community Education Family Violence Prevention Center, JBFCS
Resource Expert :
Tina Rzepnicki, Ph.D., Associate Dean, School of Social Service Administration, University of Chicago
Betty Blythe, Ph.D., Professor, School of Social Work, Boston College
12:15 - 2:15 P.M.
Break
2:15 - 2:30 P.M.
Reports from the Breakout Sessions and Open Discussion: An Agenda for the Future
Chair: Steven D. Cohen, M.P.A., Associate Executive Director, Administration and Planning, JBFCS
Breakout Session Chairs and Participants
2:20 - 3:30 P.M.
Coffee Break
3:30 - 3:45 P.M.
Workshop Reports and Discussion
3:45 P.M. - 5:00 P.M.
Moderator: Edward J. Mullen, D.S.W., Director, Center for the Study of Social Work Practice and the Willma and Albert Musher Professor, CUSSW
Report from Session on Outcomes Measurement Systems Currently In Use:
Rami Mosseri, Ph.D., Director, Residential Treatment Facilities, JBFCS
Report from Session on Health:
Grace Christ, D.S.W., Associate Professor, CUSSW
Report from Session on Mental Health/Behavioral Health:
Anne O'Sullivan, M.P.H., Consultant
Report from Session on Family and Child Welfare:
Steve D. Cohen, M.P.A., Associate Executive Director, Administration and Planning, JBFCS
Adjournment
5 P.M.
e-mail comments to: ejm3@columbia.edu
attention: Edward J. Mullen