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Monitoring of interventions for people with substance abuse and addiction problems

Monitoring of interventions for people with substance abuse and addiction problems - how do we know what works ? marco.fredin@grkom.se 0046 761-30 77 65. Why monitor outcomes from interventions? Several reasons from different perspectives:

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Monitoring of interventions for people with substance abuse and addiction problems

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  1. Monitoringof interventions for peoplewithsubstance abuse and addiction problems - how do weknowwhatworks? marco.fredin@grkom.se 0046 761-30 77 65

  2. Why monitor outcomes from interventions? Several reasons from different perspectives: • legislation and regulations from the Swedish board of health and welfare • ”open comparisons” and national inspection show that there are problems with client participation and the monitoring of interventions. • better care for people who have dependency problems

  3. “…clients’ subjective experiences of welfare and wellbeing are a central source of knowledge for those who deliver and manage social work…” ”…the overall purpose with social work is to maintain a good or improve an inadequate quality of life for those people we are trying to help…” Source: Blom, B & Morén, S (2011) Utvärdering i socialt arbete –Utgångspunkter, modeller och användning

  4. “Local monitoring is a necessary part of an evidence-based programme but also for social workers wanting to work rationally and goal-focused way without calling their work evidence-based” Source: Bergmark, A, Bergmark, Å, & Lindström, A (2011) Evidensbaserat socialt arbete, Teori, kritik, praktik

  5. Mandate from the city council: • Good quality evaluation and forward planning should involve those people who use the city’s services, in order to increase service-user influence and contribute to an improved quality of service • It is very important that we all continue to improve analyses and monitoring within our respective organisations

  6. Costs for the city of Gothenburg Net Costs 2012 • Care and treatment of adults = 160 million Swedish kronor (ca 17.7 million EUR) Benefits for the clients? What are the outcomes?

  7. Quality (indicators) in social services • Is a department effective if it: • follows the rule of law • is accessible • treats clients in a polite and respectful way • has low/high costs per user • has procedures for dealing with complaints • is based on respect for people’s integrity and their right to make their own decisions • has a high proportions of outpatient care • has well-trained staff • has agreements with other organisations

  8. The aim is that ”open comparisons” will focus much more on performance indicators Performance Outcomes from the client’s perspective Process Activities in the organisation Structural Predetermined structural conditions

  9. Reversed perspective based on outcomes Performance To measure results from the user’s perspective Process To measure processes and conditions (activities) Structural To measure predetermined structures (funding, staff etc.)

  10. UIV • Uppföljning av Insatser för Vuxna med missbruks eller beroende- • problematik. • Monitoring of Interventions for Adults with abuse or dependency • related problems

  11. The aim of UIV • To increaseclientinvolvement and togive the social worker a structurefor the interview at the end of the intervention • To increaseknowledgeabout the effectsof interventions • Feedback to policy makers on the effectivenessof the organisation • Compareoutcomeswithothermunicipalities • To show whichhealthcare providers havepositivelyratedresults for a particulartypeof intervention • To allowsettingupofgoalsthatarerelatedto benefit to the user • Contributetoincreasedquality and the betterutilisationofeconomicresources

  12. How we do this in practice • All social workers/social welfare officers interview their clients at the end of the intervention • Questions are based on a structured method with all clients being asked the same questions • Questions: • Background information (age, sex, care provider etc.) • Which intervention the client received • The client’s evaluation of the intervention • The social worker’s evaluation of the intervention

  13. Type of interventions • Inpatient care and treatment • Outpatient care • Foster care for adults

  14. National Development Council • toensuredevelopment and long-term • maintenanceof the model • representatives from regional Research and Developmentunits, universities and social workers/managers • for more information see: www.nuso.se

  15. Monitoring outcomes should guide our actions rather than plans that have no connection with benefit to the client Monitoring provide a basis for dialogue – dialogue creates possibilities for development

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