A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

Linda Barnhart,Maria Nardella,Karen A Monsen,Carla E Prock,Scott A Elsbernd,Wendy S Looman,Jacquie Stock

doi:10.1155/2013/793936

Abstract

Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems.

Highlights

Children with special health care needs (CSHCN) are at increased risk for poor health outcomes [1]
The CSHCN population is growing, the need for services is increasing, and the capacity to provide CSHCN services is decreasing due to public sector financial constraints [2]
It is critical to demonstrate the needs of this vulnerable population and evaluate the effectiveness and value of CSHCN programs [2, 3]

Summary

Introduction

Children with special health care needs (CSHCN) are at increased risk for poor health outcomes [1]. It is critical to demonstrate the needs of this vulnerable population and evaluate the effectiveness and value of CSHCN programs [2, 3]. Public health nurses (PHNs) in Washington State serving CSHCN sought to describe CSHCN client needs and evaluate CSHCN programs using a standardized terminology, the Omaha System [4]. They selected the Omaha System because many of the local Washington State public health jurisdictions used electronic health records and the Omaha System for clinical documentation. This work builds on previous efforts to describe care and evaluate outcomes in other states and programs [8]

Objectives

Methods

Results

Discussion

Conclusion