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Rural Health Information Hub

Evaluation Frameworks

Rural care coordination programs are conducting evaluations to track process and outcome measures. There are many evaluation frameworks that may be appropriate.

For descriptions of different evaluation designs and frameworks, see Evaluation Design in the Rural Community Health Toolkit.

Frameworks that have been used to evaluate care coordination programs include:

  • Anderson Behavioral Framework: This framework assesses the behaviors of patients, clinicians, and other participants, including predisposing characteristics (elements that motivate care coordination); enabling resources (elements that support or impede care coordination); need for coordination (elements that stimulate care coordination); and the coordination of health services (behavior).
  • Donabedian’s Quality Framework: This framework uses a structure-process-outcome framework to assess quality of care. Structures are the setting for care coordination, including physical or organizational aspects; processes are the modes for care coordination; and outcomes include health outcomes or other measurements.
  • Organizational Design Framework: This framework assesses the relationships among organizations or within an organization that allow them to provide high quality coordinated care. It may be used for initiatives that require organization-wide changes, such as implementing a PCMH.
  • Relational Coordination Framework: This framework assesses how teams work together and collaborate to impact quality and efficiency. It may be appropriate for evaluating the impact of a care coordination team.

It is important that the evaluation framework incorporate a continuous quality improvement approach. This means that preliminary and interim findings can be used to improve or refine the care coordination program.

Resources to Learn More

The Center For Medicare And Medicaid Innovation's Blueprint For Rapid-Cycle Evaluation Of New Care And Payment Models
Reviews a new rapid-cycle approach to evaluating continuous quality improvement efforts and program outcomes for payment and service delivery models.
Citation: Health Affairs, 32:4
Author(s): Shrank, W.
Date: 4/2013

Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 7—Care Coordination
A systematic review of quality improvement strategies, which identified over 40 definitions of care coordination. The report developed one broad working definition for care coordination.
Organization(s): Agency for Healthcare Research and Quality
Date: 6/2007

Conceptual Frameworks and Their Application to Evaluating Care Coordination Interventions
Describes four conceptual frameworks for evaluation that can be used for care coordination programs. This resource is an excerpt (Chapter 5) from Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 7 – Care Coordination.
Organization(s): Agency for Healthcare Research and Quality
Date: 6/2007

A Framework for Program Evaluation: A Gateway to Tools
Toolkit that contains information, guidelines, and a framework for community health program evaluation.
Organization(s): Community Tool Box