Opportunities To Better Understand System Of Care Dynamics: Seeking Data-Informed, Collaborative Solutions

to Community Health Challenges

Integrating Data Into Practice (IDP)Motivating Value-based Decisions

by Chris Potter, M.Ed.December, 2014

My Commitment to Integrating Data into Practice

For over 30 years, I have served within many roles delivering behavioral health services, ensuring compliance with quality of care standards, and implementing quality improvement projects on behalf of Community Mental Health Programs. I have worked in a variety of community health settings within Oregon and Minnesota, providing managerial and clinical services as: Quality Improvement Coordinator, Program Quality Analyst, Lead Clinician, Licensed Psychologist (Minnesota), Program Manager, and Supervisor.

Throughout my career, I’ve promoted value-driven quality improvement processes, developed specialized mental health programs, conducted multiple data-informed practice management projects, and delivered a broad range of clinical services for children and adults. Over the past 20 years, I’ve committed myself to providing leadership in developing and implementing protocols that empower performance improvement within healthcare organizations.

A Commitment To Data-Driven Community Health System Transformation

I started collecting and analyzing data in the late 1990’s. Over the years, I formulated three major projects toward the goal of gaining an understanding of dynamic partnerships within systems of Care, and toward developing tools that can assist ‘System of Care Partners’ in learning from the data about how their health outcomes are affected by the dynamics of partnerships within their community system of care.

Three IDP Projects: Three Data Analysis Dimensions• Each project represented a different phase of studying, understanding,

and developing materials and processes to facilitate more standardized procedures to maintain consistency throughout the project.

• Project #1 focused on the clinical relationship: – the Practitioner=Recipient of Care relationship.

The product of this project culminated in development of Symptom and functioning evaluation tools, self-monitoring forms, and self-guided coping skill development courses. Given the focus on managing stress and conflict more effectively, I called this approach ‘Assertive Self-Care (ASC).’

• Project #2 focused on the systemic organizational relationships between:– the Recipient of Services=The Practitioner=and Organizational Management.

While integrating use of balanced scorecard benchmarks, clinical and cost outcome data by program type, and desire to identify organizational feedback from each participant’s relationship, I assembled materials and a standardized quality improvement process I called “Outcome Driven System Development (ODSD).”

• Project #3 focused while working for a state government organization, I sought out models that took into consideration more complex relationships between population specific health improvement-state governmental organizations and community health organizations:

– Recipient of care=Practitioner=Organizational management=Community Stakeholders

• This approach resulted in a variety of quality assessment tools and modelling processes aimed at building more effective collaboration between state and local healthcare organizations, focusing on ‘System-of-care Partnership Analysis (SPA).’

In conclusion, there appears to be great benefit in collecting and integrating basic symptom, functioning, and performance data into clinical practices. This can prove to be useful within three ‘dimensional partnerships’:

1. in clinical practice: between practitioner and care recipient, 2. In behavioral health organization: between practitioners, care recipients, and

organizational performance managers, and3. In state health authority: between practitioners, care recipients, organizational

performance managers, and state and local stakeholdersThe following slides show how data is analyzed in each partnership dimension:

Assertive Self Care is a Solution Focused approach, building upon your strengths and skills to better handle stress and conflict in you life. This can help to improve your mood, overall. It involves use of a ‘Self-Care Plan’ on a weekly basis, highlighting your strengths/successes, your goal, and the coping tasks that might help you over the upcoming week. You are encouraged to have a ‘Coach’, or a ‘support person’, to help you stay focused on your goals, successes, and coping tools that have been helpful. Each ‘Self-Care Plan’ has daily tasks for you to practice so you can learn to better cope with stress and conflict. Each evening you can track your progress by writing in a ‘Self-Care Diary’, noting how Coping strategies affected your mood.

The Assertive Self-Care Strategies are focused on: Stress Management:

CS 1: Managing your time: pacing yourself, balancing ‘work and self-care’ CS 2: Relaxing yourself: letting go of tension, using your senses to distract yourself CS 3: Counseling yourself: encouraging yourself, focusing on strengths, perspective, and hope

Conflict Management: CS 4: Speaking out: stating what you feel, think, and want, (or don’t want), using ‘I’ statements CS 5: Solving Problems: focusing on goals, working through problems, noticing progress as you go CS 6: Expressing your feelings: using ‘feeling words’, asking yourself what you need to feel better CS 7: Working out conflict: finding common goals, solving problems together, using consequences

At the end of each week, review the comments and your Self-Care Diary. You can then decide which strategies have been most helpful, and what to focus on for the upcoming week. Your ‘Coach’ can help you to recognize successes, and encourage you to keep practicing. Good luck! Remember, success comes with practice, encouragement, and patience. Give yourself credit for all of your efforts and successes!

Project #1: Assertive Self-Care

Example of client outcome evaluation after episode of Treatment: Assertive Self-Care: Risk Factors: diabetes, sib past Resource Needs: 2 out of 11

Strengths, motivators: "I want better life"

Outcome Goal better direct my anger

Stresses/changes teenage son - abusive

Psych. Medications: Prozac

Supports: husband

CC: rb

Prescriber: 0

Appointment # 1: 9/15/05

Appointment type: i

Initial GAF: 50

Therapy Protocol: sf-sm

Level of Care (0-4): 1

age: 37

Gender F

Dx 1: dep

Dx2: anx

Substance Abuse Hx.: n

Medical complication: y

Weight complication: y

Unemployed: y

PD features: y

Filing for Social Security: 0

Last Psych Hosp.: 01/00/00

Termination code: 0

No of no shows 1 Last NS date: 11/22/05 Review Date: 1/0/00

Latest Appointment: 11/3/05

Appointment number 3

Recent GAF: 60

What's helped: When hous is clean I feel better, stopped smoking

Client current plan: get things done

Treatment Progress:

2 2 2 2

1

2 2 2

1

0

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44

3 3 3

1 11.5

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15Session Number

Num

ber o

f clie

nts

GAF 55 or less

GAF 60 or more

Number of Adult clients attending therapy by session

number per GAF group

Since most adult clients tend to stay in therapy less that 5 sessions, the treatment plan should emphasize higher impact interventions early in treatment. I made sure my client left each session with something to use, to read, or to attend to. This reality reinforced the application of Solution Focused Treatment techniques.

Percentage of all clients seen at session # with GAF 60 or more - 2003

38%

32%

57%

75%

44%

58%

64%

57%

33%

20%

0%

50%

100%

1 2 3 4 5 6 7 8 9 10

Session number

Percentage of Adult clients with a GAF score of at least ’60’, attending therapy

by session number

In the Spring of 2006, I had the opportunity to work on developing an agency wide data-supported quality improvement process, that I called “Outcome Driven System Development (ODSD).” This put into play a process of ‘Quality Improvement’ based upon a ‘Scorecard Benchmarking’ process, with monthly feedback on progress toward the established benchmark goals. In June of 2006, I started work on several initiatives with the intent:

1.To provide data trend analysis, monthly reports, and consultation for Behavioral Health Managers and Supervisors on progress toward improving productivity and clinical outcomes.

2.To assist Community Health Teams in determining and implementing service delivery improvement processes, evaluating their impact

3.To provide Supervisors, Managers, and community stakeholders with data supported reports on Clinical Productivity and Quality Outcomes as part

of Quality Improvement and Utilization management process

Outcome Driven System Development (ODSD)

Project #2: Outcome Driven System Development

Developed by Chris Potter, M. Ed.

Integrating Performance and Outcome Data into System DevelopmentIntegrating Performance and Outcome Data into System Development ProcessProcess

SystemsIntegration

Staff Productivity

Clinical Effectiven ess

Outcome Outcome Driven System Driven System

DevelopmentDevelopment

Total Services delivere d Client Serv ice Hours/month

Clinicia n Direct Serv ice hours/monthNumber of ne w cases/ month

Number of uni que i ndiv iduals seenCost of Serv ice per Lev el of Care

Efficiencies to reduce cos ts

Quali ty of care*Client S tatus Assess ment:

•Symptom/ Functi oni ng status c hange•Risk fac tors a nd res ponse•Functi oni ng Sta tus: Voca tional/Educati onal/•Coor dina tion of care be twe en prov iders

Outcomes per i nterv enti on & Populati on Group: Ev idence Based Prac tices v s. Outcomes of Sta ndar d Care

Anal ysis of Hi gh Serv ice Utilizers & Treatment v ariance be twee n clini cians:

Customer sa tisfa ctionServ ice Access time: from call to 1st appointmentSatisfac tion wi th care

Ma nage ment Str uctureStaff W orkloa d Mana ge ment:

•Documentation Timeliness•Staff Satisfaction

•Incentives for Performan ce•Recognition of Innovation

Multi-S yste m interface:

Cross-system service integrationPartner relation ships

*Assessme nt drawn from ‘Na tional Outcome Measures’, DS M IV criteria, ‘Prime -MD S urv ey’, ‘Common Fac tors i n Ps ychotherapy’

Indicator /Benchmark GoalsTeam FTE

Jan

DCs

Jan

Ave.

Feb

DCs

Feb

Ave.

Mar

DCs

Mar

Ave.

Apr

DCs

Apr

Ave.Ia.1. Clients are stable upon

completing treatment C&F 14.2

 47%

 35%

 38%

 33%

> 75% DCd clients complete treatment: per DC code

Adult 12 

39% 

21% 

35%  33%

  Discv 9 14 50% 11   22 67% 7    Sandy 8.3   29%   32%   31%      Intsv. 6 18 50% -2 29 21 21 65% 20 30%

  FmlPsy 1 

  

       %

  Crisis 10 

100%-2 

14%  17%   25%

  Psych 6.8 27 50% -2 16 10% 31 24% 16 16%  Cntrct 5       45%   78%   67%

  Agency   

  

       30%

Indicator /Benchmark GoalsTeam FTE

Jan

Total

Jan

Ave.

Feb

Total

Feb

Ave.

Mar

Total

Mar

Ave.

Apr

Total

Apr

Ave.IIa.1 Clients keep appointments C&F 14.2   91%   86%   84%   86%

80% of appointments

-Individual Sessions kept-Adult 12

 88%

 88%

 87%

  86%

  Discv 9   95%   97%   97%   88%  Sandy 8.3   87%   82%   91%   81%  Intsv. 6   90%   93%   88%   83%

  FmlPsy 1 

85% 

92% 

93%  83%

  Crisis 10   86%   91%   96%   97%  Psych 6.8   74%   78%   77%   83%  Cntrct 5   85%   70%   88%   60%  Agency

               83%

County Behavioral Services 2007 Team Scorecard - Compiled by Chris Potter, Systems Evaluator

Indicator /Benchmark Goals Team FTE

Jan

Total

Jan

Ave.

Feb

Total

Feb

Ave.

Mar

Total

Mar

Ave.

Apr

Total

Apr

Ave.

III a.1 60% Direct Service maintained

C&F14.2

 53 hours

 62 hours

 63 hours

 59 hours

Standard = 85 HOURS/month Adult 12   70 hours   70 hours   76 hours   62 hours  Discv 9   49 hours   48 hours   54 hours   52 hours  Sandy 8.3   41 hours   53 hours   54 hours   49 hours  Intsv. 6   55 hours   58 hours   54 hours   48 hours

 FmlPs

y1

  

  

 34 hours

  38 hours

  Crisis 10   22 hours   35 hours   44 hours   hours  Psych 6.8   54 hours   51 hours   40 hours   hours  Cntrct 5   89 hours   80 hours   83 hours   hours

 Agenc

y 

  

  

  

  hours

IIIb.1 Clinicians maintain appropriate caseload size to Practice

C&F14.2

 39 cases

 41 cases

 45 cases

  cases

80% of clinicians maintain appropriate caseload size

Adult 12 

48 cases 

54 cases 

57 cases  cases

  Discv 9   41 cases   41 cases   42 cases   cases  Sandy 8.3   67 cases   64 cases   55 cases   cases  Intsv. 6   14 cases   15 cases   16 cases   cases

 FmlPs

y1

 23 cases

 23 cases

 22 cases

  cases

  Crisis 10   13 cases   13 cases   12 cases   cases  Psych 6.8   127 cases   128 cases   128 cases   cases  Cntrct 5   28 cases   29 cases   27 cases   cases

 Agenc

y 

  

  

  

  cases

County Behavioral Services 2007 Team Scorecard - Compiled by Chris Potter, Systems Evaluator

Percentage of Clients Discharged, who completed treatment

26%

21%

27%28%

25% 25%

28%

23%25%

32%

27%

22%

24%

20%

28%

13%

17%

28%

0%

20%

40%

7/1/

2006

8/1/

2006

9/1/

2006

10/1

/200

6

11/1

/200

6

12/1

/200

6

1/1/

2007

2/1/

2007

3/1/

2007

4/1/

2007

5/1/

2007

6/1/

2007

7/1/

2007

8/1/

2007

9/1/

2007

10/1

/200

7

11/1

/200

7

12/1

/200

7

Yes No Linear (Yes) Linear (No)

ServerName (All) AnasaziSupervisorName (All) ClinicianType (All)

Average of PercentDischargedZeroThree

MonthOfData

ODSD?

Percentage of individuals Discharged having 'completed Tx.' (with DC code '3') against all Discharged Clients (with DC codes: '3, 2. 5, 6, 8, 9, 13')Benchmark Ia.1 > 75% clients are stable upon completing treatment

System-of-care Partnership Analysis (SPA)

System of Care Partnership Analysis (SPA) incorporated: 1.Differentiation of Quality Assurance and Quality Improvement processes, 2.Assurances that requisite state and federal Quality of Care standards were met by behavioral health organizations, and3.Promotion of effective, data-driven, quality improvement planning and review processes.

While Quality Assurance protocols were implemented to ensure applicable regulatory compliance, Community Behavioral Health Organizations were offered tools and technical assistance to develop their quality improvement processes, aimed at demonstrating progress toward meeting or exceeding statewide performance benchmarks. A primary goal of these efforts was also to build more collaborative partnerships between state and local healthcare and social service providers.

Project # 3: System of Care Partnership Analysis

* OUTCOME DRIVEN SERVICES DELIVERY MODELS

*By Chris Potter, 05/19/2008 for Transformation Team

Establish Outcome Guided System Model

Assess Team specific processes - values per product OC goal

Create ‘Performance Feedback Loop’

Product Goals: outcome measures/Pop. group High level outcomes:

o Number individuals served/ o Tx. Completion rate o Number critical incidents

Hospitalizations (pts) Deaths - Abuse Arrests – incarcerations School expulsions, etc.

Low level outcomes: o Level of Care changes o GAF/CGAS changes o Functional changes o Satisfaction with care

Quality Improvement & Certification Team: 1. Evaluate and monitor certification, variance, and site review processes by ‘value to outcome goals’

2. Link ‘processes’ to: a. Clients served b. Funding streams c. County outcomes

3. Establish benchmarks for improving outputs & outcomes

4. Publish findings

Facilitate monthly reviews of outcome data per team on 2 – 4 ‘leading

indicators’

0

10

20

30

40

50

60

1stQtr

2ndQtr

3rdQtr

4thQtr

Hospitalizations

CriticalIncidents

Completinrate

Process Goals: outcome measures:

High level outcomes: o Hospitalizations (days) o Services offered (duration) o Providers/client – patient o Evid. Bsed. Practices used

Low level outcomes: o Rule compliance rate o Provider direct service/client o Non-DS processes o Cost/intervention/client o All Interventions used, etc

Implement initiatives/steps toward adding value and efficiency:

1. Standardize Site Review protocols 2. Establish QA database 3. Coordinate with adjunctive teams to collapse redundant processes

4. Revise OARs for clarity & focus 5. Establish QI process per county Introduce OGSD concepts Offer consultation toward transformation at local levels

Facilitate Quarterly Performance Improvement Initiatives and monitor

impact:

0

20

40

60

80

100

120

Baseline Intv A:Qtr 2

individualsserved

tx completionrate

criticalincidents

Process Flow Management

Process Flow Feedback and Management: to maximize outcomes/outputs based upon demand priorities and resource availability. Continuous outcome value feedback & flow value analysis to:

o Understand resource utilization (cost/time) versus quality and quantity of service (process step) units completed o Establish process flow trends for service process managers and professionals o Motivate value improvement adjustments and initiatives o Determine impact of rapid trial initiatives

4 Partner Perspectives: Goals for System change initiatives should consider perspectives from each of the following

1. Customer 2. Provider 3. Management 4. Stakeholders and payers

Process Flow Management:

Standardization of terms, processes and value indicators Evaluation of system capacity, demand priorities, and partner inputs Development of system value improvement benchmark goals Implementation of Flow Management plan with ‘adaptively’:

o Continuous process flow feedback at all production levels o Rapid process adjustment and change initiative trials

Standardization of Processes and Performance Measures: toward DHS goal of assisting Oregonians in being independent, healthy and safe

Referral processes, Client needs assessment: Diagnostic, Level of need tool Client health and demographics profile, Outcome goals & measures: subjective and functional based Service delivery processes, interventions, Service outputs: cost and time

Service Outcomes: Treatment completion versus subjective and behavioral outcomes

Payment processes, Progress evaluation Consumer satisfaction Critical incidents

System Process Evaluation Nodes (feedback review points): Access points Assessments and Referrals Treatment or service planning Service reviews and Service termination

Critical incidents Quality Assurance Reviews Quality Improvement Process reviews Interface with partner system or contractor

* System-of-care Partnership Analysis The Golden ‘Value’ Process Cycle

Using Meaningful Metrics to Evaluate Systemic Partnership Dynamics Working Toward Balancing Whole System Dynamics with Whole Person Needs

System-of-Care Partnership Dynamics:

Partnership: ‘Intervention/Performance Process Cycle’ Assess needs & Previous Intervention Reponses

Engage Individual on Intervention Plan Implement Intervention: planned strategies

Collaborate on Care with community care partners Monitor Progress & revise strategies as required

Transition Care to Community Support Network

Utilization/Covered Population Group

Outcomes/Covered Population Group

Cost Quality

VV == VVaalluuee ooff CCaarree ‘‘BBaallaannccee’’

3-Provider Organization (Management) Partnerships

2 – Practitioner Partnerships

A

I

V T E

C M

A

I V

T E

C M

4 – Community

Stakeholder Partnerships

1 – Recipient(s) of care

Partnerships

A

I

V T E

C M

A

I

V T E

C M

A

I

V T E

C M

System-Of-Care Dynamic Transactions

Balancing Costs and Quality between Community Partnerships

Assess Health, Stress, Conflict, Abilities, Experiences,

Environment, & Resources

Implement Intervention/ Performance Improvement

Plan

Transition level of care/oversight to Community Support Network

Engage Individual in a process to

identify outcome, performance goals

Collaborate with community

health promotion/ professional

partners

Monitor Progress on plan,

& on factors contributing to

success toward goals

Golden Value

Triangle

= ‘Triangulation’ Dynamics: Indirect expression and/or actions between three ‘partner relationships’ within a system (of care) in response to competing or conflicting interests, expectations, roles, beliefs, or feelings of one or two partners.

* Community Care Organization ‘Partnership Interaction Triangulation Dynamics’

Community Care System Assessing:

Population Health, Risk factors, Needs, Resources, and Service Delivery Capacity

4 – Stakeholder

Partnerships

A

I

V T E

C M

3 – Organizational Partnership

2 – Practitioner Partnership

2 – Practitioner Partnership

1 Customer Partnership

A

I

V T E

C M

A

I

V T E

C M

3 – Organizational Partnership

1 –Customer Partnership

A

I

V T E

C M

Facilitating: Performance Empowerment Initiatives to improve:

Access to Care, Outcomes, Utilization trends (Costs), Partner Collaboration, and Motivate Healthy Behaviors/

Innovativeness

A

I

V T E

C M

Manager Perspective

Customer Perspective

Practitioner Perspective

A

I

V T E

C M

Customer

Perspective

Stakeholder Perspectives

Manager Perspective

A

I

V T E

C M

Stakeholder Perspectives

Practitioner Perspective

Customer Perspective

Caseload size – Positive outcomes VS.

Productivity – Positive outcomes

Productivity – Positive outcomes VS.

Access – Positive outcomes

Productivity – Positive outcomes VS.

Care Coordination -Positive outcomes –

Adverse outcomes - Costs VS.

Caseload size – Treatment Success

Care Coordination -Positive outcomes

VS. Access - Positive outcomes

Caseload size – Positive outcomes

VS. Access - Positive outcomes

Potential Dynamic Conflicts

Priority differences in ‘service exchange’ contracts: Partner Contract for (Desired Outcome) Partner In exchange for

Customer Easy access to services. Good attention and understanding of concerns. Interventions that help individual attain their goal. Coordination with community providers.

Practitioner Collaborative working relationship. Honest accounting of concern, symptoms, functioning, and history. Agreement to treatment plan. Willingness to monitor and report on changes, successes, and additional concerns that may arise. Reimbursement.

Practitioner Professionally delivered services. Engagement with customer. Assessment, service planning, evidence supported services delivered, and monitoring progress toward outcome expectations of customer. Collaborative problem solving with customer and community providers.

Organization Management:

Organizational structure, clear expectations & collaboration, supervision, resources, feedback, and support. Encouragement for innovative approaches that improve outcomes and/or efficiencies. Financial reimbursement from gov. contractor, insurance provider.

Organization Management:

Supervision of employees & contractors. Maintenance of Quality Assurance standards and Quality Improvement Processes. Status reports on Access, Outcomes, Critical incidents, and Utilization/costs of services. Collaborative problem solving with community partners.

Community Stakeholder groups

Community partnerships and collaborative problem solving. Equitable resource allocation, community feedback. Agreement on Service Need Priorities based upon population needs in community.

System of Care Partnership Performance Analysis Groupings

Monthly-Quarterly data reports: focused on Access and Outcomes for

Specific Populations, Service Coordination, Provider Performance

Benchmark Progress, and Community Wellness Initiative Goals and Impact

Governance Body- Provider Network Community Health Improvement Benchmarks

Target Metrics

Monthly data reports: focused on Practitioner Performance, Caseload Management, and Provider

Performance Improvement Processes to meet Benchmark Goals

Time Time

Time Time

Individual-Practitioner Intervention Plan

Management-Practitioner Performance Improvement Plan

Stakeholder-Organization Quality Improvement Initiative Plan

Quarterly data reports: focused on Provider Performance in meeting Benchmark Goals,

Population-specific health access and outcomes,

Community Wellness Initiative Impact

Target Metrics

Target Metrics

Target Metrics

Real-time Service data reports: focused on Practitioner Interventions,

Recipient follow-through, Outcomes/Satisfaction, Service

Coordination, and

Recipient’s ‘whole health’ status

Four Partner Dynamic System of Care Contracting

System Transformation

Consultation modelsSolution Focused ConsultationCollaborative Governance Dynamic Value Improvement Process

Governance System

SpecialistRole

ManagerRole

StakeholderRole

CustomerRole

Productivity

Quality

Metric

Metric

Resource acquisition

Benchmark goals

Monthly outcomes

ClinicianRole

ManagerRole

StakeholderRole

ClientRole

Productivity

Quality

Metric

MetricClinical goals

Service utilization

Clinical outcomes

Provider System

Dynamic Contracting• Value monitoring process• Required QA standards• Risk management protocols• QI Benchmarking process: • Quarterly goals• Performance indicators

• Access• Outcomes• Utilization• Service coordination

• Continual progress monitoring• (Rapid) Performance improvement

process

Addictions and Mental Health Division

July 12, 2010

2008 - 2010 CMHP Site Review Findings

Advisory committee4%

Coordination7%

Personnel6%

Policies and procedures3%

Supervision6%

Sub-contract coa2%

Documentation24%

Quality management21%

Abuse reporting3%

Consumer rights8%

Crisis services5%

Access11%

Abuse reporting

Access

Advisory committee

Consumer rights

Coordination

Crisis services

Documentation

PersonnelPolicies and procedures

Quality management

Sub-contract coa

Supervision

QIC (All) CMHP (All)

Count of Finding Type

Finding Type

Drop Series Fields Here

Data source: compilation of Community Mental Health Program regulatory compliance findings: April 2008 – May, 2010

Survey Averages by Partner Group

5.0 5.0 5.0 5.0 5.0 5.0 5.03.9 3.3 3.0 3.2

4.3 4.3 4.6 4.0 4.0 3.7 3.74.7

4.04.7

4.0 4.3 4.7 4.8 4.6 4.9 4.9

4.2 4.2 4.0 4.4 4.8 4.8 4.8

2.8 4.0 4.4 4.5

4.2 4.6 4.4

3.3 3.8 4.5 4.33.8

4.3

5.0

3.9 3.94.1 4.0 4.2

4.4 4.5

3.5 3.5 4.54.5

4.5 4.5 4.5

4.1

4.6 4.64.8

4.74.7 4.8

4.04.0

4.0 4.74.3 4.7

4.7

2.8 2.83.0 3.0 3.5 3.2 3.3

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

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ers

are

able

to g

et in

for

an

Org

aniz

atio

nal

goal

s, p

olic

ies

and

Car

e is

coo

rdin

ated

wel

l with

oth

er

Sup

ervi

sion

isav

aila

ble

for

Clin

icia

ns a

repr

oduc

tive

at

Thi

s or

gani

zatio

nw

orks

har

d to

bui

ld

Indi

vidu

als

are

able

to g

et t

he a

mou

nt o

f

Men

tal H

ealth

serv

ices

are

I, w

e(o

rgan

izat

ion/

grou

p)

Indi

vidu

als

are

able

to g

et in

for

an

Inte

rage

ncy

issu

esar

e di

scus

sed

and

Car

e is

coo

rdin

ated

wel

l with

ser

vice

Men

tal H

ealth

serv

ices

pro

vide

d

Client Clinician Manager Stakeholder

Polk Washington Columbia

Score Aveages

Partner Group Statement

County CMHP

Promoting Healthy Communities

Using Performance Metrics Effectively to Understand How Community Healthcare Systems Work and

To Influence How Health Care Decisions are Made

Engaging Community Residents and Service Providers to• Encourage Healthy Behaviors and • Foster Collaborative Solutions to Health Challenges

For more information, contact Chris Potter, M.Ed.: Pdxchrisp@MSN.com