Case Notes and Granular Categories

date: 2017-11-02
belief: likely
status: draft

Could electronic case notes in social service agencies be streamlined?

Proposal

For example, yesterday I needed about 3 minutes to make a brief note that “a client had come in seeking shelter, but was turned away until 11/15.” Why? Because submitting the case note required me to search through and correctly mark about 80 fields of meta data.

Could this meta data be more structured? Why not collapse categories under their programs?

For example:

I proposed the changes (pruning down to 10 meta fields max per program) and solicited feedback. Here’s what I heard.

Feedback

I think it is really helpful to hear different ideas and think about layouts/streamlining. I think the only hard thing is that sometimes we can give people crisis intervention, parenting support, coordinated entry, etc. in one visit. i.e. they might get one thing from each program category.

I do agree, it always seems to take me a while to fill out a case note entry, even when it is something simple. I will say, that while we do want to track what clients requested, services asked for is not required. You only need to fill out the services offered. So if I am calling a client for something, since I initiated the outreach, I don’t log what the client requested. Sometimes that saves me thirty seconds of scanning the “services requested” list.

So collapsing categories might not work if we use mutually exclusive sets.

I guess I’m not understanding your question. What do you mean [sic] make the case note streamlined? All of our staff provide services that cross over programs, so I wouldn’t collapse services into one program.

What do you mean so similar case notes are grouped together?

For reporting and data collection, if we have fewer categories, then more case notes fit into each category (pigeon hole principle). What I’m suggesting is that we set up case notes to have low granularity.

Are you saying that the “reason for visit” list should become smaller?

Yes, for two reasons: 1. fewer categories are easier for new employees & contract monitors to understand. 2. Too many categories might lead to analysis paralysis.

Other sources

Granularity is the level of depth represented by the data… High granularity means a minute, sometimes atomic grade of detail… Low granularity zooms out into a summary view of data and transactions.1

I particularly like Granularity on Wikipedia. It addresses my concern that poorly designed case notes don’t scale well, and become a meaningless burden for case managers.

Finer granularity has overheads for data input and storage. This manifests itself in a higher number of objects and methods in the object-oriented programming paradigm or more subroutine calls for procedural programming and parallel computing environments. It does however offer benefits in flexibility of data processing in treating each data field in isolation if required. A performance problem caused by excessive granularity may not reveal itself until scalability becomes an issue.

  1. https://businessintelligence.com/dictionary/granularity/