Evidencing outcomes and developing evidence to support good practice
Outcomes refer to the changes that are brought about in behaviour, attitudes or condition of people accessing the service. At an individual level, routine outcomes measurement is central to improving service quality and accountability, and ensures up-to-date information on an individual’s progress, which is of therapeutic value in itself. At an overview level, where individuals are anonymised, service users, providers and commissioners can see a performance pattern for the service.
Frameworks for assessing or measuring outcomes need to take account of the individual’s own goals, and an effective system will be sensitive to intrapersonal effects such as feeling safe, respected, listened to and helped. The highly diverse nature of individuals’ desired outcomes is a fundamental flaw in any routine outcomes system, which is likely to fail to capture subtleties of individual difference. Demonstrating outcomes represents a particular challenge for organizations working with young people with complex and enduring needs; baselines vary enormously, goals are individual, outcomes need to be clinically or therapeutically meaningful, and change may be slow as the journey toward a better life is often a very bumpy ride.
However effective outcomes measurement, tailored to individuals and the nature of work undertaken and difficulties experienced, supports ethical evidence-based practice, allows organizations to demonstrate the degree to which they provide value for money and supports a good practice model of analyse-plan-do-review. Measuring outcomes allows an organization to:
- Measure its success;
- Focus resources to achieve the greatest impact;
- Be more competitive for funding and / or fees;
- Improve program planning (by learning from what works);
- Engage with commissioners on setting outcomes in contrast to outcomes being imposed as part of fee arrangements.
Outcomes measurement frameworks can use both quantitative (hard) data and qualitative (soft) data, but outcomes measurement must be undertaken with a strong understanding of the appropriate techniques and be rooted knowledge of the organization and the context and culture of the work. When planned well from the outset, outcomes measurement is something that can and should be implemented in-house. While an organisation rarely needs ongoing outside expertise, well-focused help on the front-end can often assure a solid initial design and effective implementation.
Chris Taylor’s deep understanding and long experience in therapeutic care, coupled with practical experience of developing outcomes frameworks, means he is well placed to help your organization develop their own, tailored system.