Outcome based care puts the person firmly at the centre of the careservice and delivers meaningful individual outcomes. This has created a resultsbased accountability culture, which relies on data driven decision makingprocesses to help to improve the lives of people using care services and thecommunity as a whole. Being accountable in this way means evidence is providedfor the outcomes achieved for service users and in this way services can bejudged as to whether service users are better of as a result of the servicesinput. Key benefits of such care are, ?Services users can choose care preferred and neededto to improve their quality of life.?They can have more flexibility in choice and anychanges to need can be responded to more quickly.
?Care workers can work closely with service users toenable them to become more independent.?It strengthens partnership working?Evaluating the effectiveness of services is easierwhere outcome measures are set Outcome based practice versus Service led approach Service Led Outcome based Tools encourage information gathering through standardised question and answer approaches to assessment, support planning and review Semi-structured conversations with individuals in assessment, support planning and review ” “Tick box” approach to assessment Analytical skills involved in assessment The person is viewed as a client, service user or patient The person is a citizen with rights and responsibilities If the person is deemed eligible, identified needs are matched to a limited range of block provided services, resulting in service-driven approaches Identifying outcomes involves considering a range of solutions/strategies including the role of the person, family supports and community based resources Where needs link to strict eligibility criteria, the assessor is required to maximise individual difficulties to access services Involves consideration of difficulties, limitations and aspirations or goals. The priority is to identify what to work towards Focusing exclusively on deficits and difficulties, and how needs are to be met, results in a focus on tasks and in services which do things to people By focusing on strengths, capacities and goals, while mindful of limitations, the role of the person is maximised. Services do things with people. Matching needs/deficits to services tends to result in static service delivery Outcomes may change in the person’s life journey and so should be revisited Where outcomes are identified, these tend to be professional or organisational outcomes e.g. improved nutrition, or avoid delayed discharge Outcomes are what matter to the person, though often consistent with professional and organisational outcomes e.g.
being able to get out and about Starting from what services are currently available restricts communication and limits options Starting from the person’s priorities supports enabling relationships, creates clarity and identifies goals at an early stage. Being listened to, involved and respected supports better outcomes Source: Miller, E., Cook, A.
, Samet, W. (2009) Philosophy and PrinciplesUnderpinning a Personal Outcomes Approach. Joint Improvement Team.