What is outcomes focused care?
Outcome based care in health and social care aims to ensure that the care provided to any patient or individual is effective, efficient, and aligned with their individual needs and preferences. Here an outcome can be defined therefore, as the impact or progress of the care delivery for an individual.
Outcome focused care is an approach that involves tailoring medical interventions and support services to achieve the desired outcomes. Some of these desired outcomes could include: promoting and prolonging independence, improving quality of life, and improving wellbeing.
Currently lots of local authorities are commissioning home care on a time and task basis rather than outcomes. In order for an outcomes focused approach to be successful it involves a collaboration between healthcare providers, patients, and sometimes their families to set realistic goals to track their progress throughout their care delivery.
Through using co-production in outcome focused care, carers can concentrate on what matters to the individual, whilst families and loved ones can be reassured that their loved one is receiving the best care possible to best meet their needs and that it can be easily adapted as needs change.
Why is outcomes focused care important?
Outcomes focused care is important for a variety of different reasons. One of the main reasons why it is important is because it helps to ensure individuals live in their homes for longer by delaying future care needs.
Currently there is an estimated 6 million people aged 60 and over living with two or more long-term conditions. Because of this the needs of the older population across the UK are constantly changing. Through using an outcomes focused approach individuals, families, and care providers can discuss what an individual wants to achieve and put those services and interventions in place to allow those goals to be achieved, whilst preventing a further decline in someone’s health.
There are also more reasons why outcome focused care is important in health and social care including:
1. Delivers better person-centred care
Through using an outcomes based care, the individual is placed at the centre of their health and social care journey where their goals, preferences and values get taken into account, to lead to a more personalised and tailored care package.
2. Quality improvement
Outcomes focused care also ensures that the quality of care improves as consistent tracking of progress allows the effectiveness of treatments, interventions, and support groups to be assessed. This offers the opportunity for changes and adjustments to be made to best suit individual needs as they may change over time.
3. Better use of resources
Another reason why focusing on outcomes is important is because it helps to allocate resources more efficiently when budgets are tight. This way care providers can ensure there are enough resources to go round to meet every individual need without the risk of some individuals going without.
4. Better Accountability and Transparency
Through having clear outcomes set in place local authorities can easily evaluate and compare the performance of care providers, institutions, and systems to ensure they are commissioning the best services for the residents of their community. This then allows local authorities to have better transparency across the health and care market and be able to adjust care strategies when needed to improve outcomes further.
5. Encourages more engagement
Concentrating on outcomes allows the opportunity for individuals to be more involved in making decisions about the health and social care interventions they will receive. This allows individuals to have a more active role on their own care through increasing their engagement which in turn helps improve their attendance to these interventions.
Through encouraging more engagement this also helps to improve individuals health management as well as prevent the need for future care needs as individuals can become more proactive in managing their own health and seek extra help before something more critical takes place.
6. Reduces Costs
Outcomes focused care, when implemented correctly, also can help reduce costs to deliver the care and support needed.
Like already discussed outcomes focused care can help to prevent and delay future care needs. This allows individuals to be more proactive in managing their health so they can receive the care and support they need earlier when there is often more options for potential treatments. This helps to reduce A and E attendance and the number of unnecessary tests, treatments, and procedures being provided to help save overall health and social care costs.
Outcomes based approach in health and social care – What are the benefits?
When outcomes based care is implemented and delivered correctly it can offer a variety of benefits for local authorities, care providers, clinicians, individuals and their families. The table below demonstrates some of the benefits.
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Outcomes based approach in health and social care – How to measure it?
Outcomes based approaches in health and social care can be measured in a number of ways using several different tools and frameworks. These tools help assess progress and the impact it has had on individual health and care journeys as well as the impact it has had on the wider community.
Some of the most popular ways to measure outcomes based care include:
1. Patient-Reported Outcomes (PROs)
PROs are questionnaires or surveys that get completed by patients/individuals to report their own health status, symptoms, and quality of life. These can be very useful as they provide valuable insights into how patients perceive their condition and the impact of the interventions individuals receive.
2. Clinical Outcome Assessments (COAs)
COAs are an example of another tool used to measure clinical outcomes, such as symptom severity as well as overall health. Sometimes this type of measure can also include more standardised assessments undertaken by different healthcare professionals including a variety of questionnaires or tests.
3. Health-Related Quality of Life (HRQoL)
These types of measures assess the impact of a health condition or treatments on an individual’s wellbeing and quality of life.
This can be a good indicator to see whether the treatment and individual has received has been right for them by being able to evaluating the individual impact it has had on them. Here this data can be compared and analysed to identify gaps in the market and improve service deliveries further.
4. Clinical Pathways and Guidelines
These standardised care pathways and guidelines outline evidence-based interventions and expected outcomes for specific conditions to ensure there is consistency across the community in the care delivery.
5. Patient Engagement Platforms
Here these types of technological platforms allow individuals to actively engage in their care and track their progress towards their personalised goals.
Previously a lot of outcomes would be collating manually or via paper but through offering a digital platform to individuals across the community you can offer the opportunity for both providers and individuals alike to have access to the information they need all in one place in the palm of their hands.
6. The Recover Star Method
An example of a method which has seen a lot of success within the health and social care industry is the Recovery Star Method.
Here a 10-point questionnaire is provided to both the care giver and also the service user to allow a gap analysis to be done.
This method now tends to assess a person’s recovery from mental ill health where the term recovery is used more holistically as a way to describe a person’s growth following the development of a mental health problem.
In many cases a combination of tools and frameworks are used simultaneously to help with the evaluation of care delivery to help providers and local authorities make better data-led decisions to continuously improve on outcomes which matter to the residents in your local area.
Due to many local authorities using a variety of methods to measure outcomes-focused care it is important to have a consistent way to store and monitor all the data and information your local authority will collect. Without it there is the risk of information being lost or being stored in various places which can be time consuming as well as limit the opportunity for outcomes to be improved. It is important therefore that plans are made to move approaches digitally to remove the administrative burden so any new scores can immediately be factored in and alerts can be sent when any aspect of a service ser’s care requires change or further intervention.
The development of outcomes focused care
The concept of outcomes focused care has evolved significantly over time. The development of outcomes focused care has shifted over time predominantly due to changes in health and social care philosophy as well as an increased emphasis outcome focused care in the NHS’ Long Term Plan.
Initially however, the roots of outcomes-focused care can be identified due to the increased priority of ensuring positive clinical outcomes. During the 1980s and 1990s the importance of person-centred care started to gain traction. At this point the importance in involving individuals when making decisions about their health and social care became more and more widespread.
Overtime value-based care approaches started to emerge. These models prioritised achieving the best possible outcomes for individuals whilst managing costs. This is where the importance of tracking outcomes, patient satisfaction, and cost-effectiveness became a main focus for health and social care providers so that they could yield meaningful results and improve outcomes further.
Now with advances in technology and data analytics more accurate tracking and analysis of outcomes can take place through using electronic health records (EHRs), wearable devices, digital telecare, and better health monitoring systems to inform better data-led decisions about treatments and interventions.
Here it is clear that outcomes-focused care has evolved over time naturally progressing from more traditional clinical practices, to more person-centred care and evidence-based approaches to focus on what matters to the individual. This progression has been shaped by a combination of factors including technological advances, advances in medical knowledge, changes in philosophy, and quality improvement efforts.
Due to these technological innovations there are now several different tools and frameworks to measure outcomes-focused care in health and social care to assess progress, treatment effectiveness, and the achievement of desired outcomes.
Like with any innovations and implementations of digital technology implementing these tools can cause some challenges. The rest of this article will review these challenges and how best to overcome them to get the best outcomes possible.
What are the challenges of delivering outcome focused care?
When delivering outcomes-focused care there are some challenges that providers must address to ensure they deliver the best quality care possible which meets all the individual needs. Below is a list of some of the most common challenges your local authority need to be aware of.
1.Complexity of needs
One of the biggest challenges to overcome is being able to commission care to adapt to all the care needs within your community whilst staying in budget. As demand is increasing and with older people now often living with more than one chronic condition, it can be challenging making sure that there are enough resources available to reach demand, as well as the support needed when needs change too.
The struggles to reach demand with limiting budgets as well as additional challenges facing the social care market including retaining and recruiting carers, makes it even more difficult to ensure all the different complex needs are met. These resource constraints can then impact the ability to deliver comprehensive outcomes-focused care, especially in domiciliary care.
The limited time constraints then making it harder for local authorities to change their way of working and therefore leaves many commissioning home care on a time and task basis rather than outcomes. In the long term this can then lead to longer waiting times to receive support and treatments as well as increase the risk of longer waiting times to receive hospital beds, as well as longer discharge delays due to only having a limited availability to provide support in individuals’ homes. It can also increase the likelihood of staff burnout where carers will be overstretched with limited resources to reach the demand needed.
Equally individuals can also respond to treatments very differently due to a number of factors including genetics, lifestyle, socioeconomic status, and cultural differences therefore making it even harder to predict and achieve consistent outcomes.
2. Data collection and integration
One of the next key challenges which local authorities and care providers need to be aware of and address is how they collect and integrate the correct data they need to produce meaningful and positive outcomes for their residents.
In order to deliver the best outcomes focused care your local authority will need to collect data from various sources such as electronic health records, patient surveys, and telehealth sensors.
What can make the data collection and integration even harder is the lack of standardised measures for certain conditions or procedures. The lack of standard measures therefore can increase the risk of enabling consistent assessment and comparisons of outcomes across different care and health settings and limit the ability to identify gaps in care delivery to know where to improve more in the future.
Due to these lack of standard measures it can then make analysing outcomes and translating the data into actionable insights even more complex as well as increasing the risk of people being left with their needs unmet.
3. Inadequate training
As well as limited resources and time facing the social and health care market, another key challenge to address when delivering outcome focused care is the quality of training providers and carers receive.
As the demand increases the need for more providers and carers is crucial. This can often lead to providers and carers lacking necessary training and skills to effectively engage patients into setting goals, tracking outcomes, and using outcomes to guide treatment decisions.
Equally, when shifting from one care model to an outcomes based approach it requires changes in an organisation’s culture and workflow. This can face resistance from both providers and individuals and one of the biggest reasons for the resistance from providers is due to the lack of time providers have to learn new approaches.
These time constraints can be challenging as additional time will be needed to learn about the approach, as well as deliver additional time to individuals to improve engagement, set goals with them and undertake continuous assessments of outcomes.
4. Engagement and Compliance
Another challenge which is important to be aware of is how best to ensure individuals are engaged within their health journeys. However in order for this to happen it is crucial that regulations and policies evolve. If these are not done correctly there is an increased risk way outcomes-based care is delivered and incentivised will be very different across a community.
A lack of engagement across the board therefore limits the quality of the care being delivered, enhancing the challenges facing the health and social care market further.
5. Health Disparities
One of the final challenges which is essential for local authorities to be aware of is that across a local community there can be a variety of health disparities which can them limit the effectiveness and impact of the outcome-focused care delivered.
Some of these health disparities include: socioeconomic, racial, and geographical disparities which can affect both the access to care individuals can have and their outcomes altogether. This therefore can massively inhibit the chance to achieve equitable outcomes for all individuals.
In order to overcome these challenges all local authorities must follow a multidimensional approach that involves collaboration among health and social care providers and professionals as well as the individuals themselves, and technology experts to get the best out of the approach. Once these challenges are overcome local authorities can then be exposed to the benefits and the full potential of outcomes-focused care and how it can improve the overall quality of care delivered across the health and social care market.
The rest of the article below will review and evaluate the best ways to overcome these challenges to deliver the best person-centred outcomes based care possible.
Outcomes based approach in health and social care – Best ways to measure it
To deliver the best outcomes based approach in health and social care it is vital your local authority uses a comprehensive and collaborative approach. In order to do this there are a variety of strategies to use and follow to ensure everyone involved knows and understands what the approach is and why it is important, how to standarised the measures for a better continuity of care, and finally how technology can help bring everything altogether.
1. Develop stronger multidisciplinary teams
One of the most important ways to overcome the challenges when implementing outcomes-based care is ensuring it is a collaborative approach. In order to do this everyone involved must be educated on the importance of it and individuals must know and understand the importance of goal-setting and decision making to promote more active participation.
Through having better collaborative approaches, when more expertise is needed it can be arranged more easily and quickly. This can help care plans to be tailored to overcome any health disparities which might currently be present in your local authority.
2. Better future planning
Another way you can ensure that your local authority overcomes the challenges of implementing outcome based care in health and social care is through ensuring you have better resource allocation and future planning to ensure you can consistently reach demand without going over budget.
One of the best ways to do this is through demand modelling where you can use historic data to better understand previous behaviour to receive more accurate predictions into future service demands. Demand modelling technology also relies on receiving up to date information to improve the predictions further and adapt and plan for future demands more accordingly.
At The Access Group our Access PAMMS suite offers a variety of digital tools to have better planning both now and in the future to ensure your local authority delivers the best care possible whilst also being able to compare your care delivery with neighbouring local authorities. This also ensures that the care services you commission will be at the best price possible and that you can easily share resources to prevent you going over budget but still deliver the best continuity of care.
3. Ensure you commission interventions strategically
Like discussed previously every individual could have different health and social care needs which can constantly evolve. In order to keep up with the changes in demand it is crucial you commission your health and social care services strategically to get the best outcomes possible.
By using outcomes-based commissioning your local authority can be more strategic in its commissioning so you can build upon your current commissioning practices but get a more efficient quality service in the long-run.
In order to ensure strategic commissioning can be implemented successfully in health and social care services we have worked with NHS England to ensure our Access Adam Care Commissioning software provides your local authority the flexibility it needs to automate reports whilst aligning with patient level datasets for continuing healthcare to ensure outcomes continuously improve.
One of our customers, Milton Keynes Council, found that through investing and digitally transforming their processes they were able to gain full visibility of their market to identify where changes needed to happen to improve outcomes further.
Through using our Access Adam Transport solution they were able to gain full visibility of their routes to improve their route planning which allows all SEN children in their area access to the education they deserve to enable them to be more independent, whilst saving both time and costs in the long-term.
4. Ensure all care and support delivered is person-centred
One of the other ways to ensure outcomes consistently improve is through delivering person-centred care. To do this it is essential that both care providers and health and social care professionals understand that every individual will have different health and social goals they will want to achieve.
In addition there are also different frameworks and goals which local authorities need to follow from the Outcomes based approach framework as well as the NHS’ Long Term Plan.
Through ensuring all care is person centred you can concentrate on what matters to the individual to delay future care needs as well as promote independence.
At The Access Group we know how important it is to facilitate increased independence so individuals can stay in their homes for longer and how essential it is that individuals take an active role in their health and social care journey.
Our Access Assure offering gives you the visibility you need to deliver better preventative and proactive person-centred care. Here our digital telecare ecosystem helps commissioners and care providers across the care continuum to help independent living goals be achieved to create a stronger and more sustainable care delivery.
Here Assure can support the transformation of traditional care provision models and help your care providers and local authorities be more outcomes focused. Our advanced data aggregation platform can record and highlight typical day-to-day routines and behaviours of individuals in a matter of 14 days to allow carers and loved ones to be notified in any changes of behaviour before anything more critical happens.
Our latest integration with the Assure Home hub and our care planning solution offers carers enhanced visibility to smart alerts and alarms from the hub in their care planning app so all the information they need is all in one place. This, in turn, enables better proactive care to be delivered by being able to reduce risks and identify issues before they occur from the more enhanced activity information they can access between visits.
5. Promote the importance of mental wellbeing
A final strategy which can help improve the outcomes-focused care approach is by educating your residents about the importance of managing your own wellbeing and understanding how wider determinants of health can impact how you feel on a day-to-day basis and what can happen both physically and mentally when it is not addressed.
In order to manage someone’s wellbeing more efficiently our social prescribing software offers a great opportunity for residents to be more involved in their health and social care journeys through working with Social Prescribing Link Workers on what matters to them.
Through this process data can be collected all in one place to provide safe and assured pathways and track how different interventions and support networks are influencing and improving a citizen’s wellbeing score. This information can then be easily analysed to identify where there are gaps in provision across the community so no one is left with their needs unmet.
Summarising the importance of outcomes-focused care in health and social care
In this article I have summarized what outcomes-focused care is and why this approach is important in health and social care. Through highlighting the many challenges health and social care providers and professionals are facing across the market currently, this article has been able to breakdown the various benefits outcomes based care can offer individuals and their families, as well as commissioners, carers, clinicians and other health and social care professionals.
This article has also addressed the different challenges which can occur when implementing outcomes-focused care and how best to overcome them, as well as the importance of updating processes to be digital as it offers the opportunity for the masses of data your local authority will be collecting to be all stored in one place to ensure not just individual goals are achieved, but local and national targets too.
For more information on how to implement better outcomes-focused care discover our local government software today.
Contact us and we can figure first hand what are the most important outcomes you want to improve in your local area and how we can help you achieve that.