Current Evaluation Projects
The Bree Collaborative has developed a new evaluation design process for all new guidelines. An evaluation subcommittees will create an evaluation plan and tools, in parallel with the guidelines development, that the Bree staff will operationalize.
For guidelines developed before 2023, Bree staff (describe)
We are using both qualitative and quantitative methods for evaluation of our guidelines and are interested in evaluating five broad areas of our work:
- Guideline usefulness and clarity
- Uptake and Concordance of Care
- Barriers and facilitator
- Equity
- Metrics and impact of guideline
Whether you are already on a workgroup or just interested in helping design evaluation plans, consider joining one of our work group evaluation subcommittee’s. Information for each topic is available below.
Join an Evaluation Subcommittee
2024 Guideline Evaluation Planning
If you are interested in joining the subcommittee please message Karie Nicholas at knicholas@qualityhealth.org. This subcomittee will convene starting June 1, 2025.
Background
Psychosis involves “… some loss of contact with reality… [where] a person’s thoughts and perceptions are disrupted…[and they] may have difficulty recognizing [what is] real and [unreal]”[i] that can be part of a variety of diagnoses including schizophrenia, bipolar disorder, and depression. Psychosis impacts ~3/100 people at some time in their life and 100,000 people over 21 years old annually nationwide.[ii] However, only about 10-15% of people experiencing their first episode of psychosis receive an evidence-based coordinated specialty care model.[iii] The best practice is intervention within the first three months of symptom onset that decreases psychosis duration, probability of recurrence, lifetime cost, and improves quality of life. In Washington State, over 4,300 people with Medicaid received their first psychotic disorder diagnosis in 2021, with an estimated incidence of 235/100,000 Medicaid enrollees annually.[iv] Incongruent coverage between public and private payors creates barriers to access for people on private or employer-sponsored plans
If you are interested in joining this subcommittee please message Karie Nicholas knicholas@qualityhealth.org. This subcommittee will convene beginning June 1, 2015.
Background
29.6% of Washingtonians have been told by a provider that they have high blood pressure (HTN), and prevalence varies between those living in urban and rural settings.ii Black individuals have disproportionate rates of HTN prevalence and higher complication burden which is likely the outcome of inadequate therapy and control. Washingtonians do not receive the same standard of care across the state with variation in therapy selection and care delivery models. Many patients require multiple medications to control their blood pressure; consensus guidelines for medication selection are based on clinical improvement rather than drug class and often requires BP monitoring and dose titration, which can lead to clinical inertia and ineffective blood pressure control. HTN is one of the most common conditions in the United States – approximately 110,000 lives could be saved across all marketplace segments nationally if all plans met and sustained the 66th percentile for the HEDIS measure for Controlling Blood Pressure (CBP). Aligning stratified quality metrics for blood pressure control to drive quality improvement centered on reducing inequities in quality of care can save the lives of many Washingtonians!
If you are interested in joining the subcommittee please message Karie Nicholas at knicholas@qualityhealth.org. This subcommittee will convene starting June 1, 2025.
Background
Modifiable attributes of patient health status such as anemia or blood sugar control can have negative consequences for recovery after surgery. Preoperatively anemic individuals have higher costs generally due to increased length of stay[i] and even mild preoperative anemia is associated with an increase in 30-day morbidity[ii] lower quality of recovery and higher adjusted risk of death and disability.[iii] Some studies suggest poor A1c control preoperatively increases morbidity and mortality,[iv] but perioperative glucose is a stronger predictor of 30-day mortality.[v] Enhanced Recovery After Surgery (ERAS) protocols improve length of stay and reduce total cost of care, complications, and readmissions.[vi] However, Washington State has variation for A1c optimization before surgery, perioperative glycemic control protocols, and perioperative anemia control. Black patients are three to four times more likely to experience anemia perioperatively; Black, Hispanic, American Indian/Alaska Native patients more likely to experience uncontrolled diabetes/serum glucose, leading to inequitable outcomes.
TOPIC SPECIFIC DATA CALLS
Perinatal Behavioral Health
The perinatal work group expressed an interest in collecting baseline data for the guidelines they created in order to measure changes to processes of care. In response, the Bree has designed a difference-in-differences evaluation plan to measure the change in processes and impact of implementation using a combination of process measures collected through a survey and metrics data collected through OB COAP.
Aims
- To measure impact of guidelines implementation
- To determine which activities had the most impact on the outcomes
- To understand if or how the use of equity data may have contributed to the outcome
- To understand which guideline areas provided the most support for implementation
- To understand which barriers and facilitators were most highly correlated with successful implementation.
Benefits of Participation
Any organizations that participates in the 2024 and 2027 process data collection efforts will be eligible for the Bree Collaborative’s Pathfinder Award and, subsequently, the Foundation for Health Care Quality’s Mountain Climber Award.
Who should be involved?
- Hospitals
- Hospital Systems that offer perinatal care
- Outpatient services that offer perinatal care
- Health Plans that cover Perinatal Care
- Pediatricians
- Other organizations that offer behavioral health services to pregnant and postpartum patients
What kind of support documentation should be included?
Supporting documentation may include links in the score card to webpages or documents, examples of policies, procedures, workflows, patient information, quality metrics data, or other items that demonstrate ways to operationalize guideline recommendations.
How is the data being used?
All data submitted to the Bree Collaborative will be used to populate dashboards and all participants will be de-identified.
2024
- Baseline data collection January 2024-December 2024
- Implementation Plan Survey Open December 1st, 2024
- OB COAP cross reference of participants
2025
- Implementation Plan Survey Close January 31st, 2025
- OB COAP impact metrics data collection, January 1st to January 31st 2025 for 2023-24 data.
2026
- Re-survey of process (baseline) data September 1st, 2026 to December 31st 2026.
- Guideline Usefulness Survey, September 1st, 2026 to December 31st, 2026.
- OB COAP impact metrics data collection, January 1st to January 31st 2026 for 2025 data.
2027
- OB COAP impact metrics data collection, January 1st to January 31st 2027 for 2026 data
- Bree Implementation Support Activities data collection, January/February 2027 for dates between January of 2025 and December of 2026.
- Final Data Analysis
Data Collection tools for baseline data can be found in the Bree Collaborative Implementation Guide under the Perinatal Behavioral Health section. The collection tools can be found in the Metrics and Evaluation Tools section and are listed by audience type.
Those submitting baseline data should fill out the data collection tab that is applicable to their role or “audience type” (i.e. pediatrician, outpatient, hospital, etc.) and the equity tab.
The completed score cards can be submitted using the form below, along with any supporting documentation. You may also email a zip file to: knicholas@qualityhealth.org Please put Perinatal Behavioral Health Baseline Data in the subject line.
ON-GOING DATA SUBMISSIONS
Evaluation “score cards” are available for most Bree guidelines. The purpose of these score cards it to collect standardized data on the extent to which organizational policies, contracting, programs, and care processes are concordant with the guidelines. Score Cards can be found in our IMPLEMENTATION GUIDE.
These score cards are used for a variety of purposes including awards, populating dashboards, and reports. Any organizations that submits a score card will be eligible to receive one of our AWARDS .
Has your organization use the Bree guidelines to inform your work? Have you conducted an evaluation of a project that used our guidelines?
The Bree Collaborative would like to understand the outcomes and impact our guidelines have had on organizational level work. Consider sharing your evaluation with us and let us highlight your hard work through webinar participation, awards, an other activities. Email our Evaluation and Measurement Manager for more information – Karie Nicholas knicholas@qualityhealth.org.
Submit a survey question to the Evaluation Survey Question Bank!
This tool can be found on our website. It is modeled after the CDC Question Bank and allows multiple organizations to use the same questions when they perform PDSAs or evaluate programs or implementation projects. The aim of the question bank is to help organizations use validated questions or survey tools and reduce the burden of evaluation work and improve the validity of their findings.Our Question Bank can be found HERE
Submit a survey that you have used (expand)
Contact us about developing a Case study!
Each year the Bree chooses a topic area to develop new case studies that can illustrate impact and demonstrate the “how to” of implementation. Your project doesn’t need to be on one of our defined topics in order to submit a suggestion, we are always open to new and interesting ways that organizations have used our guidelines.
2024 – Opioid Prescribing and Treatment
2025 – Outpatient Infection Prevention and focus on Employer/purchaser participation in evaluation
We currently do not have any open surveys for evaluation.
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