Current Evaluation Projects
In an effort to help align evidence across the health care ecosystem, the Bree convenes an evaluation subcommittees during the guideline development process. The subcommittee is tasked with identifying relevant measures, developing a Theory of Change, creating an evaluation framework, and reviewing topic specific evaluation tools.
The Bree is recommending and pursuing both qualitative and quantitative methods for evaluation focusing on five broad areas:
- Guideline usefulness and clarity
- Uptake and Concordance of Care
- Barriers and facilitator
- Equity
- Outcomes and impact of guideline
Whether you are already on a workgroup or just interested in helping design evaluation plans, consider joining one of our work group evaluation subcommittee’s. Information for each topic is available below.
Join an Evaluation Subcommittee
2024 Guideline Evaluation Planning
If you are interested in joining the subcommittee please message Karie Nicholas at knicholas@qualityhealth.org. This subcommittee will convene on the 4th Monday of the month from 1-2pm starting on June 22nd.
Background
As the population continues to age quickly, the risk Alzheimer’s disease and other dementias increases. In 2020, there were around 125,116 people living with dementia, including Alzheimer’s disease, in Washington state. By 2040, this number is expected to exceed 270,000 people.[i] Individuals living with dementia are hospitalized 2-3 times as often as people of the similar age who do not live with dementia, and estimated cost of medical care for people living with dementia in 2019 was around $50,000.[ii] Washington Medicare beneficiaries living with dementia are significantly more costly than beneficiaries without dementia ($2,229 Per Member Per Month (PMPM) versus $803 PMPM). Early diagnosis is associated with a per-person savings of on average $64,000. People who identify with historically underserved or minoritized populations are less likely than those who identify as White to be diagnosed, are usually diagnosed at a later stage, are less likely to use hospice care, and have a higher risk of hospitalization.[iii] Many people also experience mild cognitive impairment (MCI) that can progress to dementia,[iv] and new biomarker testing strategies can indicate people at higher risk with and without mild cognitive impairment.[v] Since the original Bree Collaborative repot, new evidence has emerged around modifiable risk factors, testing and diagnosis, treatments, care strategies, and payment methodologies, as well as a new Washington State Plan to Address Alzheimer’s Disease and Other Dementias. Updating and aligning recommendations could enhance practices in preventing, diagnosing and treating dementia to improve outcomes and provide cost savings for all Washingtonians.
Deliverables:
The subcommittee will develop a Theory of Change and an Evaluation Framework. The documents will be distributed to all guideline audiences and used to align state and private evaluation of the implementation of Bree recommendations.
If you are interested in joining this subcommittee please message Karie Nicholas knicholas@qualityhealth.org. This subcommittee will convene on the last Tuesday of each month from 3-4pm, starting June 30th.
Background
Each year, about 1.3 million individuals enter menopause, yet over one-third with symptoms go undiagnosed.[i] Fewer than 20% are identified before menopause, and rural residents facing greater barriers to treatment.[ii] Symptoms often affect daily life, and appropriate screening and management is crucial for long-term health. On average, women spend more of their lives in poor health, and addressing gender gaps in care could boost the global economy by over $1 trillion by 2040.[iii] Whole-person care for the transition through menopause includes identifying peri/menopause early, using shared decision-making to guide treatment decisions, and screening and monitoring practices for whole-person midlife health, including cardiometabolic health, bone density, mental health concerns, urogenital and sexual health, thyroid and cancer screening, etc. Clear, evidence-informed perimenopause and menopause care guidelines could improve outcomes and quality of life in Washington state.
Deliverables:
The subcommittee will develop a Theory of Change and an Evaluation Framework. The documents will be distributed to all guideline audiences and used to align state and private evaluation of the implementation of Bree recommendations.
If you are interested in joining the subcommittee please message Karie Nicholas at knicholas@qualityhealth.org. This subcommittee will convene on the 4th Monday of the Month from 2-3pm, beginning June 22nd.
Background
Tobacco use is the third leading risk factor for death and disability in Washington state, with lung cancer being a major cause of mortality.[i] Early detection through lung cancer screening results in significantly improved survival at 20 years,[ii] but only 14.1% of high-risk Washingtonians are adequately screened for lung cancer, placing the state 26th nationwide in screening rates for high-risk individuals.[iii] The chances of surviving lung cancer greatly increases by stage of diagnosis; while over 50% of diagnoses occur once the cancer has spread, those diagnosed before it has spread have a significantly higher chance of survival.[iv] Some folks are less likely to receive adequate lung cancer screening including those who identify as Black or Hispanic.[v] Additionally, smoking-related health care costs in Washington amount to $2.8 billion annually, with $2.2 billion lost in productivity each year.[vi] While e-cigarette use is not currently a qualifying factor for lung cancer screening, many individuals use both and current e-cigarette users are 21% less likely to have undergone lung cancer screening (LCS).[vii]
Deliverables:
The subcommittee will develop a Theory of Change and an Evaluation Framework. The documents will be distributed to all guideline audiences and used to align state and private evaluation of the implementation of Bree recommendations.
ON-GOING DATA SUBMISSIONS
Evaluation “score cards” are available for most Bree guidelines. The purpose of these score cards it to collect standardized data on the extent to which organizational policies, contracting, programs, and care processes are concordant with the guidelines. Score Cards can be found in our IMPLEMENTATION GUIDE.
These score cards are used for a variety of purposes including awards, populating dashboards, and reports. Any organizations that submits a score card will be eligible to receive one of our AWARDS .
Has your organization use the Bree guidelines to inform your work? Have you conducted an evaluation of a project that used our guidelines?
The Bree Collaborative would like to understand the outcomes and impact our guidelines have had on organizational level work. Consider sharing your evaluation with us and let us highlight your hard work through webinar participation, awards, an other activities. Email our Evaluation and Measurement Manager for more information – Karie Nicholas knicholas@qualityhealth.org.
Submit a survey question or full survey to the Evaluation Survey Question Bank
This tool can be found on our website. It is modeled after the CDC Question Bank and allows multiple organizations to use the same questions when they perform PDSAs or evaluate programs or implementation projects. The aim of the question bank is to help organizations use validated questions or survey tools and reduce the burden of evaluation work and improve the validity of their findings. Organizations can also submit complete surveys. Our Question Bank can be found HERE and our Survey Bank can be found HERE.
Submit a measurement definition to the Measurement Bank
Similar to the survey question bank, the measurement bank allows organizations to submit definitions for their home-grown measures for use by others. The aim of the question bank is to help organizations create measure alignment where it currently doesn’t exist. Our Measurement Bank can be found HERE
Contact us about developing a Case study
Each year the Bree chooses a topic area to develop new case studies that can illustrate impact and demonstrate the “how to” of implementation. Your project doesn’t need to be on one of our defined topics in order to submit a suggestion, we are always open to new and interesting ways that organizations have used our guidelines. You can read our current case studies or submit ideas for your own HERE.
We currently do not have any open surveys for evaluation.
© 2026 Foundation for Health Care Quality | Privacy Statement | Disclaimer