Indicators of Coordination
Our 37 indicators identify ways to measure progress in specific aspects of coordination.
Review of the literature and input from stakeholders across sectors informed our selection of indicators.
Click (+) to expand each domain and see the subdomains and subsequent indicators.
INPUTS - IMPLEMENTATION SYSTEM
I-1 Job descriptions clearly define expectations and accountability for assessment, screening, referral, linkage, and follow through. 1,7
I-2 Formal policy clearly defines WHO is responsible for assessment, screening, referral, linkage, and follow through.14
I-3 Formal policy clearly defines the timing and scope of training for home visiting staff around assessment, screening, referral, linkage, and follow through. 1,7
I-4 Formal training for home visiting staff focuses on assessment, screening, referral, linkage, and follow-through with other service providers. 1,7
I-5 Home visiting staff are competent in using a family-centered approach when coordinating services with families with diverse background, strengths, & needs. 15
I-6 Supervisors support and monitor staff around assessment, screening, referral, linkage, and follow through.1, 7
I-7 Home visiting staff use supervision or coaching data regarding assessment, referrals, linkages, and follow-through to drive improvements in processes.8
I-8 Formal policy clearly defines accountability for measurement, reporting, and reviewing outcomes for coordination in the management information systems.8
I-9 Management information systems maintain data specific to screening, referral, linkage and follow through.8
I-10 Home visiting staff use a data system to inform decisions regarding coordinating services for families.8
I-11 Formal agreements or memoranda of understanding support communication between home visiting programs and other agencies.5, 14
I-12 Formal policy clearly defines the primacy of the family in deciding what and with whom information is shared. 14
Activities
A-1 Home visiting staff understand the roles of other community providers with regard to serving families.1, 7, 9
A-2 Families participate in a comprehensive assessment of strengths and needs.9
A-3 Family assessment includes consideration of both formal and informal supports (professional, friends, and relatives).15
A-4 Home visiting staff screen families/children for [XX] with a standardized tool.
Note. XX refers to maternal depression, intimate partner violence, maternal substance use, or child development delay.
A-5 Families have a goal plan.1, 5, 7
A-6 Goal plans have clearly specified family-centered goals for home visiting.1, 7
A-7 Goal plans clearly document that family preferences were incorporated.9, 13
A-8 Goal plans incorporate families’ formal and informal supports (professionals, friends, and relatives).14
A-9 Family agreement for exchange of information about [XX] screening results is documented in record.3
A-10 Home visiting staff offer a referral to families with a positive screen for [XX] who are not already in services.4
A-11 Home visiting staff provide referral information specific to [XX] to families with positive screens for [XX].6
A-12 Home visiting staff provide key information to the family about the referral (such as logistics, nature of services provided).7, 12
A-13 Home visiting staff provide pertinent information about the family to the community provider at the time of the referral (e.g., reason for referral; family needs and preferences).5, 7, 12
A-14 Home visiting staff provide a warm-hand-off to families who receive referrals to community organizations (this refers to connecting a caregiver with a provider in real time, in person or by phone).
Note. XX refers to maternal depression, intimate partner violence, maternal substance use, or child development delay.
A-15 Home visiting staff follow up with families who received referrals to learn about the family’s understanding and next steps.
A-16 Home visiting staff follow up with families who received but did not complete referrals to learn why referral was not completed.15
A-17 Home visitors review the goal plan monthly with families and update as needed.13, 14
A-18 Home visitors use specific strategies (e.g., coaching, motivational interviewing) to promote self-care, progress toward goals, and self-sufficiency.12
A-19 Home visiting staff are actively engaged in community discussions regarding the evolving needs of the community, gaps in services, and the capacity to serve all families in need of services.1, 7, 9, 11
A-20 Home visiting staff participate in community health planning activities.
Short-Term Program Outcomes
O-1 Families receive all of the expected home visits each month. 1,4,7,12
O-2 Families report satisfaction with home visiting services. 1,7,12
O-3 Families remain enrolled in home visiting for recommended time period. 1,7,12
O-4 Number of referrals of families meeting eligibility requirements within a 6 month period.5
O-5 Home visiting programs give feedback about family progress to community providers.
References
Indicators were adapted from the following sources: 1)ANA (2013); 2) Antonelli et al. (2009); 3) French & Scholle (2010); 4) Mackrain (2016); 5) JBA (2014); 6) HRSA (2016); 7) McDonald et al. (2014); 8) NIRN (2015); 9) NQF (2014); 10) PEW Charitable Trusts (2015); 11) Preskill et al. (n.d.); 12) Schultz et al. (2013); 13) Singer et al. (2011); 14) Snyder et al. (2012); 15) Proposed by Expert Panel