The multiattribute evaluation of program-planning contractors

This note describes how the theory of measurable multiattribute value functions was used to evaluate the proposals of three competing subcontractors for a program-planning project undertaken by Los Alamos National Laboratory. The purpose of the program-planning project was to develop a methodology for the evaluation of alternative long-range strategies for the achievement of controlled thermonuclear fusion. A measurable multiattribute value function was developed based on eleven criteria. Eight judges made evaluations on each of these criteria, and their judgments were synthesized to identify the winning subcontractor. While we emphasize details associated with this specific application, we expect the problem structure and methodology to be amenable to other contractor-and proposal-evaluation efforts after only minor modifications.     

Patient progress modelling and results in Wilm's Tumour

The report describes the development of a mathematical model of the progress of patients with Wilm's Tumour using the methodology developed by Jackson & Aspden [1, 2]. The model incorporates two prognostic factors which are shown to influence patient progress. These are the stage of the tumour and the age of the patient at presentation. The model proved adequate to represent an initial set of patient data, and comparison runs were performed with data from a later time period. These runs highlighted changes in patient progress between the two groups and illustrated the usefulness of the model in this type of analysis. The analysis also underlined the poor prognosis of patients over 5 years old who relapsed.     

Using a NIATx based local learning collaborative for performance improvement

Local governments play an important role in improving substance abuse and mental health services. The structure of the local learning collaborative requires careful attention to old relationships and challenges local governmental leaders to help move participants from a competitive to collaborative environment. This study describes one county's experience applying the NIATx process improvement model via a local learning collaborative. Local substance abuse and mental health agencies participated in two local learning collaboratives designed to improve client retention in substance abuse treatment and client access to mental health services. Results of changes implemented at the provider level on access and retention are outlined. The process of implementing evidence-based practices by using the Plan-Do-Study-Act rapid-cycle change is a powerful combination for change at the local level. Key lessons include: creating a clear plan and shared vision, recognizing that one size does not fit all, using data can help fuel participant engagement, a long collaborative may benefit from breaking it into smaller segments, and paying providers to offset costs of participation enhances their engagement. The experience gained in Onondaga County, New York, offers insights that serve as a foundation for using the local learning collaborative in other community-based organizations.