Welcome to the TCOM Conversations blog. The purpose of this blog is to create an open forum for us all to share our experiences with the TCOM approach and…converse! With this, we can share in our goals and provide guidance to others J
So, lets start with a simple WHO, WHAT, WHY, AND HOW
WHO: We are the Praed Foundation and Chapin Hall at the University of Chicago. Founded in 1998, the Praed Foundation’s mission is to support effective human serving systems through the use of collaborative outcomes management approaches. Founded in 1984 as a research organization, Chapin Hall supports the kind of research that helps improve the policies and programs intended to promote the well-being of children, youth, and their families. Working together, we provide information to the policymakers and service providers whose decisions directly influence the resources available to young people, their families, and their communities.
Now we know the who, but WHAT exactly are we trying to accomplish and WHY?
We can all agree that it “takes a village to raise a child,” but what does that mean??? Well, a village is a community, fixed or transient, and a community is made up of people. In order for this village to raise a child, it seems fitting that people should be talk, communicate, even collaborate with one another. This where TCOM comes in!
Transformational Collaborative Outcomes Management (TCOM) is a method of outcomes management approach for human serving enterprises that focuses on managing positive change through collaborative, consensus-based processes that focus on the person or people served. Originally called Total Clinical Outcomes Management, the name of the approach was changed at the annual collaborative conference in Chicago to reflect the shifting role of outcomes management in human serving systems. When TCOM was first published, the debate in the field was between quality management and outcome management. The name for TCOM was chosen to reflect a shift in focus AWAY from process of care type management strategies à managing the clinical status of people in care. It’s clear that a focus on process without attention to impact was ineffective at best and TCOM, by definition, aims to emphasize this process.
LETS SPELL IT OUT!
Transformational—The focus is on change, not status at discharge. TCOM proposes that the human serving systems are not actually services, they are transformational offerings. As such the focus is not on spending time with people but rather on helping people change their lives. In this theory status at discharge outcomes are misleading since one achieves a good status at discharge by selecting people to serve who have a good status at enrollment. This may be logical in a service system but it is counter-indicated in a transformational system.
Collaborative—The focus is on developing and managing a shared vision. The concept of collaboration is that if the collaborative is successful then everyone in the collaboration gets what they need. By succeeding together everyone succeeds individually. Collaboration at the individual level is called engagement. Collaboration at the program level is called teaming. Collaboration at the system level is called system integration. Despite different labels they all share the same basic values. The only way collaborations work is if there is a shared vision in the collaborative. The idea of TCOM is that this shared vision is the people served in that system.
Outcomes—All transformation offering have common goals. As such, the focus of management decision making should be on those goals. Different human serving enterprises are working to achieve different types of positive personal change. Flexibility in management approaches are necessary to ensure that each program is managing its specific outcomes while still staying true to the systems definition of the shared vision.
Management—Once collected, information about the people served should guide all key decisions in the system. And included in these decisions are those made at the person level (e.g. treatment planning, placement, level of care), decisions made at the program level (e.g. eligibility, program design), and those made at the system level. Commonly the key decisions can be identified as such….
HOW do we hope to accomplish this?…
Well, TCOM has a philosophy a strategy and tactics. The philosophy is described above, all key decisions should be informed primarily by person characteristics. In order to achieve that goal, however, strategies are necessarily. So, specific collaborative assessment processes have been developed to support the TCOM philosophy. These include the Child and Adolescent Needs and Strengths (CANS), Family Advocacy and Support Tool (FAST) and Adult Needs and Strengths Assessment (ANSA). Thus these commonly used measures are strategies that fit the philosophy of TCOM and allow us all to use an understanding of the people we serve to guide us in all decisions.
For more information, check out the Praed Foundation
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