The Client Outcomes report lists the data that client outcomes are based on, not actual client outcomes. For actual client outcomes use the Client Outcomes Summary report. The Client Outcomes Summary report first finds all the items to consider based on the search criteria. Then it goes through all those items and for each client picks out the first and last items. Finally it averages the difference between the first and last items for all the clients, and that is the information it is giving you. In other words the FirstVal is the average of the first values of that criteria for all the clients, and the LastVal is the average of the last values for that criteria for all the clients. You can double click on the lines at the bottom to dig deeper into what items it is pulling from. The "Last Event" field is also special in that it limits what the last item is. For example, if you select "Discharge Summary" for the Last Event, then it ignores any clients that don't have a Discharge Item as the latest item in their chart. That is useful to see how you did overall for all discharged clients.

The process for generating client outcomes is based on capturing the data your organization wants to base client outcomes on, and that is accomplished in different ways based on what kind of data is needed. By default data is pulled from treatment plans and discharge summaries, and consists mainly of various scores like ACE, CAR, and CATS. Capturing outcome data entails some overhead, so it is disabled by default.