Transformational Collaborative Outcomes Management (TCOM)
The Department of Behavioral Health (DBH) integrates the Transformational Collaborative Outcomes Management (TCOM) framework into the daily care of mental health consumers within San Bernardino County. The TCOM system was developed by the Praed Foundation in 1998 and specific tools have been modified by DBH and Praed in an effort to ensure that the needs of the County’s specific population are addressed. These tools are the Adult Needs and Strengths – San Bernardino and the Child and Adolescent Needs and Strengths – San Bernardino. Below is a summary definition of TCOM:
| Transformational | Focus on change and impact to all levels of activities | |
| Collaborative | Information is integrated into all activities with the consumer, family, and staff as full partners | |
| Outcomes | Measures are relevant to decisions about and evaluation of interventions | |
| Management | Information is used to manage services, from an individual consumer level to supervision to individual programs to the entire system of care |
TCOM is used to assist service providers in communicating the shared vision that was developed in collaboration with each client. A fundamental element of TCOM is the inclusion of communimetrics principles. Some of the principles are described below and are discussed in great detail during TCOM certification training.
Six Key Components of a Communimetric Tool
- Each item has implications for differential action. They impact service planning.
- Levels of items translate immediately into action levels.
- It is about the consumer, not the consumer within services. Measurement must take into account the context, including:
- Services already in place
- Culture
- Development
- Measurement is descriptive and minimizes cause-effect assumptions. It is about the “‘what,” not about the “why.”
- Apply an observation window (e.g., 30 days) to keep assessments relevant and fresh, but observation windows can be trumped by the action levels.
- Information Integration – Multiple inputs of information may be combined to generate a measurement.
- Not a self-report measure
- Not solely a measure of clinical impression
