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Measuring what’s important

Measuring what’s important. Monitoring Outcomes Doug Gosling. My messages. Monitoring outcomes and the effectiveness of services is undeveloped Monitoring outcomes - individual and whole service - is not technically difficult There are complex barriers to effective monitoring

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Measuring what’s important

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  1. Measuring what’s important Monitoring Outcomes Doug Gosling Measuring what’s important

  2. My messages • Monitoring outcomes and the effectiveness of services is undeveloped • Monitoring outcomes - individual and whole service - is not technically difficult • There are complex barriers to effective monitoring • There are important lessons from our wider lives! Measuring what’s important

  3. My outcomes for today? • Your immediate reaction to what I present, esp. enthusiasm, challenge? • What you take back as useable ideas? • How you monitoring of outcomes improves in (define period)? • Understand (or be reminded about) chiasmus – fun but irrelevant?! • It may be comparatively evidence light, but is intended to be idea rich Measuring what’s important

  4. Wider Life • We are more experienced at buying outcome based services than we might think – though not in social care • Examples • Key Lessons: • Trust, which grows over time • Buyer has measure(s) of success Measuring what’s important

  5. Monitoring Outcomes • CSIP survey (June 2006): No authorities (15) were monitoring outcomes • CSIP think tanks (Autumn 2007): No authorities (30) were monitoring service outcomes • Commissioning network request: limited response, still some confusion of outputs and outcomes Measuring what’s important

  6. Monitoring outcomes:the essentials • Agree outcome(s) expected: service and individual • Identify what shows they have been achieved • Collect information to measure achievement - individual • Collate individual information to obtain measure of service effectiveness • USE THE RESULTS TO ACHIEVE CHANGE Measuring what’s important

  7. Monitoring outcomes: Connie • Outcome: Wears her hearing aid without reminder • Measure: Whether staff have had to help or remind her • Information: Daily log records and reviews, where progress and achievement over period is recorded • BUT, given her forgetfulness, will she ever acquire the skill and/or do it unprompted? (In which case, does it remain an output task: insert Connie’s hearing aid?) Measuring what’s important

  8. Collating outcome measures • Representation of an individual's progress on several fronts, e.g. the outcome star • Collating measures from several service users to monitor the effectiveness of the service Measuring what’s important

  9. Example of star Ref: http://www.mungos.org/about/Training%20&%20Consultancy.htm And The London Housing Foundation and Triangle Consulting, via www.lhf.org.uk Measuring what’s important

  10. Suggested Benefits • For clients • More accurate assessment of their progress • Validates clients journey of recovery • Client centred tool • For staff • Identifies appropriate interventions • Guides the work • Improves confidence • For organisations • Better assessment leads to better outcomes • Improved effectiveness • Demonstrability of results Measuring what’s important

  11. Service effectiveness • All service users have outcomes, but variable number and focus • Progress monitored on simple scale: 0= no progress 1= progress, less than 50% 2= progress above 50 but not complete 3= full achievement • Effectiveness score and profile Measuring what’s important

  12. Service Effectiveness Measuring what’s important

  13. Service Effectiveness - example Measuring what’s important

  14. Barriers to effective monitoring? • Contracts not based on purchasing outcomes, accepted across the whole system • Care management – focus on outcomes • User/informal carers – are they involved enough in identifying and agreeing individual outcomes? • Contract monitoring resources – numbers and competences? • Integration of different levels of outcomes, especially timescale and strategic – individual • Knowledge barriers – cause and effect, satisfaction and effectiveness, outputs and outcomes • OVERALL SHIFT IN CULTURE AND PRACTICE Measuring what’s important

  15. Remember the lessons from wider life • Mutual trust • Measure(s) of whether you have got what you paid for • The supplier expects you to check you have a satisfactory outcome Measuring what’s important

  16. Have I been effective? • Immediate – have more than 75% of you rated me X or higher on all scales? (Is this actually satisfaction?) • Have you got greater knowledge and/or confidence about monitoring outcomes? How many of you? How much greater? • How much have the systems you work with moved on in say six to twelve months? Are you monitoring service effectiveness? • Sewing ideas: germination and growth are influenced by a multitude of other factors. Measuring what’s important

  17. Finally: chiasmus You must measure what is important You must not make important what you can measure Measuring what’s important

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