Phase 3: Case Studies of Outcome Measurement Implementation
The purpose of phase #3 is to identify existing outcome measurement programs used by states and organizations in which HCBS outcome measures are being implemented. This study will use qualitative case study methods to compare and contrast these programs in relation to measure implementation procedures. Comprehensive case studies will be conducted of varied existing quality measurement approaches and programs that will identify the similarities and differences across procedures and mechanisms across states and organizations supporting the HCBS service recipients. Review of procedural manuals, on-site interviews, data collection methods (including assistive technology use, tablet and smartphone use), and observations as well as a review of written materials and documents about each program will be conducted. From these case studies, RTC/OM staff will be able to identify those procedures and mechanisms that can have negative and positive effects on the usability of the outcome measures to inform service and systems improvement. Case studies will be completed at the organization and state systems levels. The outcome of this study will be the development of a procedure and mechanism practice guidebook that includes recommendations and identifies common challenges in implementing outcome measure programs related to HCBS to assist federal agencies, states, and organizations.
The methodology, guided by the study research questions, will remain open-ended because the questions are framed to maximize the possibility of obtaining new insights, and draw on various sources of information including: 1) documents and written materials, 2) existing data, 3) in-depth interviews, and 4) observations. This methodology is based on inductive analysis of information from different sources that often identify practices that are so taken for granted by participants that they cannot describe or explain them and yields descriptive reports that examine practices and strategies in the context of the organization/agency that developed them. Qualitative research methods are used to provide a rich understanding of the phenomena studied.
Phase #3 includes a series of case studies of HCBS and other outcome measurement programs in order to identify effective attributes of programmatic implementation that are designed to enhance implementation fidelity.