Basic concepts in mental health evaluation: integrating program evaluation and medical audit.
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Evaluation Studies as Topic↗
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Results for “Program Evaluation”
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Can program evaluation be saved from its enthusiasts?
Program evaluation--the use of scientific techniques to measure the value of an agency's work--has become the focus of major attention and enthusiasm in mental health service planning and administration. However, the author points out that completed program evaluation studies are few in number and provide no evidence of great impact on the operation of programs or agencies and that unrealistic enthusiasm for program evaluation can lead to unrealistic rejection when performance fails to reach promise. He concludes that program evaluation should be applied only when it can have an impact, i.e., in a limited number of carefully selected cases.
Community Mental Health Services↗
A model for program evaluation in a unitized setting.
The unitized psychiatric hospital poses unique problems for the design of successful program evaluation systems. Using the model of program evaluation in operation at the Harlem Valley Psychiatric Center in New York, the authors describe what they have found to be essential components of a successful evaluation system, including methods of data input, processing, and feedback. Also discussed are the roles of key personnel and the utilization of data by clinical and administrative staff. The reasons for success of the system are discussed, as well as the potential role of program evaluation in integrating services, training, and administration of the facility.
Aftercare↗
A reinforcement exchange analysis of the power aspects of program evaluation.
Power, examined within a reinforcement exchange model, is proposed as an essential dynamism through which program evaluation is mounted, executed, and utilized. The ability of the program evaluator to influence or control the policies or operations of the evaluatee depends chiefly on an exchange of behaviors which nets all participants of the evaluation interaction a fair and sufficient "payoff" in terms of contingent reinforcements. Other contextual features of program evaluation, particularly those that constrain on utilization of the recommendations, are briefly discussed.
Attitude of Health Personnel↗
Community influences on mental health program evaluation.
Research in community psychology has demonstrated that community environments can play a key role in defining the operations of human service institutions. This study questioned whether significant community groups might indirectly influence the program evaluation record-keeping of mental health outpatient programs to reflect contact with problem areas considered important by those groups. An inventory of program evaluation materials was conducted in three types of mental health programs. The ranked frequencies of record completion for 10 designated problem areas were correlated with staff rankings of importance for agency work with problems identified by key community groups. Results indicate that the more important the community demand is to the staff, the more systematically complete will be data sources which document agency performance for that demand. Given the general lack of comprehensive development of program evaluation in many mental health programs, the results suggest that community interest groups may play a major role in determining what types of information on mental health problems are made available to the public. The resultant lack of balance and scope in these data inevitably limit the range of community responses for program improvement.
Community Mental Health Services↗
Program evaluation--a systematic means of program improvement.
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Education, Nursing↗
Do we really want a program evaluation strategy based solely on individualized goals? A critique of goal attainment scaling.
Goal attainment scaling is a program evaluation technique that measures program success using individualized client goals rather than the same measuring instrument for all clients. Although the reliability of the goal attainment scales is generally acceptable, such scales have not exhibited satisfactory validity. Also when clients have not been assigned to programs randomly, evaluations comparing two or more programs using goal attainment scales are potentially more biased than evaluations that use the same outcome measure for all clients. Thus since goal attainment scaling does have therapeutic value, program evaluators should adopt a multivariate assessment strategy combining goal attainment scaling with uniform measuring instruments.
Community Mental Health Services↗
Program evaluation of a physical medicine and rehabilitation unit: a new approach.
Rehabilitation units must meet the increasing demand for empirical documentation of the quality of care patients receive. Hospitals wanting to do program evaluations will find few published materials providing norms by which to judge the adequacy of the functional outcomes achieved by their rehabilitation patients. The purpose of this research was to develop an approach to program evaluation that would serve the accreditation needs and would be relatively inexpensive to implement. Sixty-nine consecutive admissions for cerebral vascular accidents (CVA) were assessed on activities of daily living (ADL) and cognition using a behaviorally defined procedure called the "Level of Rehabilitation Scale" that was developed for program evaluation purposes. Nurses and spouses of patients were interviewed to obtain the observations that were rated. Further ratings on ADL and cognition were made at discharge. Those at home 6 weeks and 4 1/2 months after discharge were assessed on the same scales and on home-relevant activities. Experience with the instrument showed that ratings of function can be made in a reliable and valid fashion. The research provides the beginning of the accumulation of improvement norms for CVA inpatients and documents maintenance of improvement 4 1/2 months after discharge. Hospitals and rehabilitation units can utilize these norms and this method of program evaluation economically using nonclinically trained staff.
Activities of Daily Living↗
Let's quit stalling and do program evaluation.
Five issues have been identified as major impediments to program evaluation. Examination of these issues shows many of them to be resolved in the process of conducting evaluations. It is asserted that only by implementing evaluations will the field move foreward. At the present time much energy is wasted discussing or arguing the five issues and the ideal approach to making program evaluations. Examples are provided from ongoing evaluations that show how the issues are resolved.
Community Mental Health Services↗
Essential features of a faculty evaluation program.
A faculty evaluation system should be developed by cooperation between evaluation specialists and dental faculty. The system should depend on a broad spectrum of data collected from a variety of sources in order to reduce personal bias and subjective judgments concerning the performance of all faculty members. Its primary purpose should be to help faculty improve and to this end should be linked to both a faculty development program and a reward system. The criteria for each faculty member's evaluation should be clearly specified in advance and be directly linked to his duties. Department and college goals must be considered as well as the individual faculty member's own interests. Standards or criteria for both rewards and sanctions should be clearly defined, and guidelines for the operation of the system should be given to each participant. The system itself should not cost more than the benefits derived from it justify, and adequate resources should be allocated to make the system effective.
Costs and Cost Analysis↗
Integration of quality assurance and program evaluation activities in alcoholism treatment programs: Part I.
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Alcohol Drinking↗
Program evaluation techniques in the health services.
This article addresses the issue of program evaluation in the area of health services; examples are drawn from the field of mental health. Current arguments concerning the goals, characteristics, and methodologies of program evaluation are discussed and two generally useful quantitative evaluation models are presented. The models are compared and their advantages for clinicians and administrators are detailed.
Cost-Benefit Analysis↗
Program evaluation research: an experimental cost-effectiveness analysis of an armed robbery intervention program.
An armed robbery alarm system was implemented in 48 different stores in two separate geographical areas for 6 months and 12 months, respectively. The alarms were placed in the two separate areas at different times and all alarms were eventually removed. Thus, multiple baseline and reversal strategies were used to evaluate program impact. A device planted in a cash drawer was triggered whenever "bait" money was removed from the drawer sending an alarm signal directly to police cars and headquarters. On-scene apprehensions of armed robbers within target stores were greatly increased even though the armed robbery systems did not deter robbery incidents nor influence the court disposition of the cases. There was also no crime deterrence, crime displacement, or increased apprehensions in either the immediate neighborhoods of target stores or on a city-wide basis. The cost effectiveness of the program was calculated to be poor even though the program is being maintained because of the absence of an alternative robbery apprehension technology.
Cost-Benefit Analysis↗
Program evaluation for effective resource management and accountability.
A means of determining the effectiveness of public programs as a basis for justifying resource allocation to these programs is urgently needed. Program evaluation can provide the data base required for program decision-making and modification. A ten-step model for planning and carrying out an evaluation is suggested as a guideline for program personnel who may be assigned to evaluation responsibilities. Nutrition professionals must become aware of the increasing need for evaluation and of the procedures for conducting the evaluation process within programs for which they are responsible. Failure to provide documentation of adequate, on-going evaluation of effectiveness may lead to a loss of resources for the program and, ultimately, to the demise of the nutritional care program.
Evaluation Studies as Topic↗
A mathematical model of speedskating performance improvement for goal setting and program evaluation.
An analysis of world class performance improvement over chronological time was used to develop mathematical curves of performance for each speedskating event. The equations were calculated using an unconstrained non-linear least squares iterative curve-fitting technique. A non-linear model was selected to satisfy the principle of diminishing returns, that is, it is more difficult to achieve a unit of performance improvement as performance approaches the theoretical limits of man. Minimum criteria of acceptance for each curve were: 1) the coefficient of determination must be 0.90; 2) the year 2000 predicted value must be less than the current world record; and 3) the curve must be progressive, i.e. satisfy the principle of diminishing returns. Satisfactory curves were calculated for seven of the eight male and female events studied. A four year Olympic cycle was noted and a definite change in performance trend was identified as occurring in the mid 1960's. The calculated mathematical curves can be used in three applications: 1) setting objective individual goals and evaluating these goals; 2) evaluating and comparing training programs on successive years; and 3) evaluating total programs.
Female↗
Program evaluation as health services research.
Evaluation of health program is necessary for more rational allocation of scarce resources. Steps in evaluation include: 1)Specification of the program goals, 2) Description of the program, 3) Definition and measurement of outcome, 4) Assessment of intervening variables, 5) Analysis of data, and 6) Implementation of findings. Examples from impirical evaluation studies are presented to illustrate one practical application of these steps. While the random controlled trial is a most powerful tool, it is very difficult to apply in complex human services programs. In the future, more use of multivariate matching of groups to approximate a quasi experimental situation will be needed. Education of health professionals in methods of evaluation is necessary to promote planned improvement in health services.
Boston↗
The politics of program evaluation: the mental health experience.
The authors discuss evaluation studies of the community mental health centers program. The emphasize that program evaluation is a political activity to influence the allocation of public resources. They examine its relationship to decision-making, power conflicts, and bureaucratic goals. They point out that the evaluator is seldom totally objective. They also emphasize the increasing use of evaluation by politicians.
Community Mental Health Services↗
Program evaluation of Texas mental health and mental retardation centers.
The diversity of programs offered by the 24 mental health and mental retardation centers in Texas required that program evaluation take a management-by-objectives approach, with each center examined as a unique system with its own goals, techniques, and activities. The approach required the centers to develop statements of management objectives, which they did with varying degrees of success. The evaluations were carried out by site-visit teams. The authors describe the evaluation process, the difficulties encountered, and some of the beneficial effects.
Community Mental Health Services↗