This final chapter provides words of encouragement and hopefully inspiration.

This chapter explains why it is critical to measure health outcomes. It includes a review of the current measurement landscape in health care in the context of the Donabedian framework for assessing health care quality. It also reorients the reader to a focus on measuring outcomes and outlines why measuring outcomes can be challenging but must be done. The chapter also provides the reader with prompts for self-reflection on their outcome measurement aspirations and describes who the intended audience is for the guide.

This chapter discusses the four main reasons to measure outcomes: 1. measuring the change in outcomes tells you how you are doing with respect to providing health care; 2. with outcome data you can identify opportunities for learning and improvement; 3. outcome data give patients and their families critical information about what to expect when they seek care from you or your organization (or, if you work for a payer organization or employer, from the health care providers within your network); and 4. you have an ethical obligation to understand whether the care you provide is helping or harming.

This chapter describes different ways to identify outcome measures once the outcomes that matter most are identified. These outcome measures can be used to see if outcomes are improving or not. The chapter also gives an example of how to organize chosen outcome measures using the Capability, Comfort, and Calm framework. Guiding principles for narrowing an outcome measure set to a small set of actionable measures are outlined.

This chapter focuses on the mechanics of collecting and analyzing outcome data. It reviews the foundational functions of data management as they pertain to measuring outcomes. Then it discusses different data collection mechanisms such as using spreadsheets, REDCap, registries, and electronic health records. Additional considerations for data collection are outlined such as establishing the measurement timeline and ethical and legal considerations when establishing an outcome measurement program. This chapter also discusses the steps of integrating and validating data as well as extracting and analyzing outcome data. The primary audience for this chapter is individual clinicians who want to start measuring outcomes in their clinical practice.

This chapter discusses how to grow an outcome measurement team in a single clinical practice and covers how outcome measurement can look at scale within larger organizations that have built capabilities to leverage their electronic health records for data collection and analytics. The key steps of data management functions are referenced again to illustrate how these functions can be deployed at scale to measure outcomes. Key personnel needed to support outcome measurement at scale are also explained. Considerations for sharing data with broad audiences is described, specifically the stages of data acceptance are reviewed. Governance and leadership considerations are briefly referenced. The primary audience for this chapter is health care administrators who want to start measuring outcomes in their organization or support existing efforts.

This chapter describes what it means to measure the outcomes that matter most to people and describes the Capability, Comfort, and Calm outcome measurement framework developed by Elizabeth Teisberg and Scott Wallace.This framework orients measurement and improvement efforts around achieving health and the outcomes that matter most to patients. It also helps reframe existing measurement efforts into a framework that facilitates measuring the results of health care. This chapter outlines the following key principles in measuring health outcomes: measure at the individual patient level and measure during the course of care.

This chapter establishes a basic vocabulary in measuring outcomes as the first step in getting started to measure. It then outlines the steps in getting started: 1. identifying the cohort or segment; 2) gathering baseline data (retrospectively and prospectively); and 3. identifying the outcomes that matter most to people. It also addresses where to start based on if you are a clinician or health care administrator either from a provider organization or payer organization.A table is included that describes the different types of data and data sources that can be used for baseline data gathering as well as the advantages and disadvantages of each.