Potential Measures for Clinical-Community Relationships

A Supplement to the Clinical-Community Relationships Atlas

Community Resource Element: Clinic/Clinician-Community Resource Relationships

Potential Measure JJ
ItemDescription
TitleUtility of “bridging resources” / informational tools used by clinicians to foster relationships with community resources
DescriptionThis measure assesses clinicians’ perceived value from the use of bridging resources/tools to facilitate referrals to community resources.
DomainClinician experience (clinic/clinician-community resource).
Data sourceClinic/clinician survey.
Calculation methodThis measure may be reported as the percentage of clinics/clinicians who report that the bridging resources/informational tools they use to make referrals to community resources in a community are useful.
NotesMeasure may also collect qualitative information on ease of use, utility of resource, quality of information, or other aspects of usefulness relevant to the measurement goals.

Measure responses may be compared to perspective of community resources.

Similar to measure LL of clinic/clinician-community resource relationship
Potential Measure KK
ItemDescription
TitleValue of clinical-community resource relationship
DescriptionThis measure assesses the level of perceived value of clinical-community resource relationships from the perspective of community resources.
DomainCommunity resource experience (clinic/clinician-community resource)
Data sourceCommunity resource survey
Calculation methodThis measure may be reported the average level of perceived value of clinical-community resource relationships reported by community resources in a community.
NotesN/A

Potential Measure LL
ItemDescription
TitleUtility of “bridging resources”/informational tools used by community resources to foster relationship with clinic/clinicians
DescriptionThis measure assesses community resources’ perceived value from the use of bridging resources/tools to facilitate referrals from clinicians.
DomainCommunity resource experience (clinic/clinician-community resource)
Data sourceCommunity resource survey
Calculation methodThis measure may be reported as the percentage of community resources in a community that report that the bridging resources/informational tools they use to complete referrals from a clinic/clinician are useful.
NotesMeasure may also collect qualitative information on ease of use, utility of resource, quality of information, or other aspects of usefulness relevant to the measurement goals.
Measure responses may be compared to perspective of clinics/clinicians.

Similar to measure JJ of clinic/clinician-community resource relationship
Potential Measure MM
ItemDescription
TitleCosts to the clinic/clinician and a community resource to establish a clinical-community relationship
DescriptionThis measure assesses the costs associated with establishing a relationship between a clinic/clinician and community resource organization.
DomainCost/efficiency (clinic/clinician-community resource).
Data sourceAudit – Using administrative management data to determine costs of establishing clinical-community relationships for both the clinicians and the community resources
Calculation methodThis measure may report as the cost associated with establishing a particular clinical-community relationship.
NotesMeasure may consider various start-up costs including staff time, staff salaries, hiring costs, training time, technology infrastructure costs, opportunity costs, etc.
Potential Measure NN
ItemDescription
TitleCosts to the clinic/clinician and a community resource to maintain a clinical-community relationship
DescriptionThis measure assesses the costs associated with maintaining a relationship between a clinic/clinician and community resource organization.
DomainCost/efficiency (clinic/clinician-community resource)
Data sourceAudit – Using administrative management data to determine costs of maintaining clinical-community relationships for both the clinicians and the community resources
Calculation methodThis measure may report the costs associated with maintaining a particular clinical-community relationship.
NotesMeasure should consider new compensation policy for delivering preventive services and using community resources to do so.

Measure may consider various costs including staff time, staff salaries, opportunity costs, licensing, etc.
Potential Measure OO
ItemDescription
TitleStrength of a clinical-community resource relationship
DescriptionThis measure assesses the strength of a relationship between a particular community resource and a particular primary care clinic/clinical practice
DomainNature and strength of the inter-organizational relationship (clinic/clinician-community resource)
Data sourceAudit – A standardized evaluation form would be used to assess a clinical-community relationship’s attributes and determine how strong the relationship is.
Calculation methodThis measure may be reported on an ordinal scale that includes rating of elements such as networking, coordinating, cooperating, and collaborating. While this measure applies to a particular clinical-community relationship, it might also be of interest to assess all of the relationships that an organization engages in or all the relationships within a community to understand how the relationships differ.
NotesPrinciples for this measure may be adapted from Himmelman’s model of collaboration for a change:
http://depts.washington.edu/ccph/pdf_files/4achange.pdf

The audit would need to consider/evaluate both the clinic/clinician and the community resource.
Potential Measure PP
ItemDescription
TitlePercentage of referrals to a community resource that are actionable
DescriptionThis measure reports the percentage of referrals that a community resource receives that include all necessary information for the community resource to take action.
DomainReferral process (clinic/clinician-community resource)
Data sourceAudit – Auditor would review administrative clinical data to determine whether referrals are actionable by a community resource.
Calculation methodThis measure may be assessed for a particular community resource or for all community resources in a community. It may be targeted to community resources participating in a clinical-community relationship or be reported more generally. This measure may be reported as the percentage of referrals received that include all necessary information for the community resource to begin the process of delivering services.
NotesA referral may be actionable even if the service is not actually delivered.
Potential Measure QQ
ItemDescription
TitleTime to provide preventive services by a community resource
DescriptionThis measure assesses the time it takes a community resource to provide preventive services once the community resource receives a referral from a clinic/clinician.
DomainTimeliness (clinic/clinician-community resource)
Data sourceAudit – A review of administrative or clinical data at the community resource to determine the amount of time it takes the community resource to provide preventive services once it receives referrals from clinic/clinicians
Calculation methodThis measure may be reported for individual community resource organizations or community resource organizations within a defined community as a whole. It may be targeted to community resources participating in a clinical-community relationship or be reported more generally. It may be reported as the average amount of time between the receipt of a referral and the delivery of the service averaged across all referrals for which the service is delivered.
NotesThis is related to measure VV, the percentage of referrals from a clinician to a community resource that result in the delivery of the preventive service.
Current as of October 2013
Internet Citation: Potential Measures for Clinical-Community Relationships: A Supplement to the Clinical-Community Relationships Atlas. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/resources/ccrm-atlas-suppl/ccrm-atlas3-5.html