Person-centred care: measuring impact
A key concern within integrated, personalised care is demonstrating the changes or impacts achieved. The aims are long term, reshaping the way that care is delivered (and received) and will take time to embed and filter through to improved health outcomes for patients.
So what evidence can commissioners, and others, show in the short term to demonstrate that their initiatives are working?
Quite simply, they can show that they are changing the way that healthcare is being experienced by patients. If commissioners can show that consultants, nurses, patients and carers are changing the way they interact, they can show that their programme is, in the short term, moving in the right direction. This is the first step in achieving change and builds an evidence base on which longer term outcomes can be attached.
So how do you demonstrate change?
Commissioners we spoke to told us that it can be really valuable to show what the changes to service usage actually look like on the ground. Showing the different ways that patients are being involved in their own care or decisions around their care can be really powerful. This could be patients perceiving the importance of self-managing their own care or being invited by the clinician to help decide between several treatment options.
OPM have already contributed to work carried out by the Health Foundation, reviewing approaches to measuring whether person-centred care is taking place. Our work for South East Commissioning Support Unit built on this work and focused on identifying measures for two specific areas: Shared Decision Making and Self-Management. These measures, for example the SHARED Scale and Patient Enablement Instrument, allow commissioners to demonstrate in a very tangible way that patients are playing a more active role in their care. By contributing to decisions about what care is appropriate for them, and taking a role in managing their own care, patients are moving away from a deference to, and dependence on, primary care practitioners.
We produced a searchable database of tools which can be used to demonstrate that interactions and relationships between patients and health care practitioners are changing, in specific and real ways. We shared these resources with commissioners and health care providers across three workshops to enable them to start using the tools.
We found that commissioners really appreciated this type of support. When we shared our database, and a framework for integrating it into project implementation, commissioners told us that it:
- helps them connect those doing the strategic thinking with the changes actually taking place on the ground
- helps them apply a strategic approach across multiple programmes, capturing data to compare between programmes and report consistently across a wider programme of work
- gives them the confidence to select validated measures which they can recommend for use within projects
- helps them provide clear guidance to providers about the measures that should be included within their programmes.
This positive feedback gives us confidence that this is a tool that will genuinely add value for commissioners. Participants that came to our demonstration workshops told us that in partnership with the tools for person-centred care , they have a solid foundation for implementing more robust programmes that create both impact and learning for the future.
We encourage all those working in this area to share their experience. It’s a new field of working and our workshops showed that everyone is keen to learn what works from those who are implementing change on the ground.
This is the second in a series of blogs to be published following the development of a set of online tools and resources by OPM in support of the person-centred care agenda for South East Commissioning Support Unit. The first is entitled: Person-centred care: putting patients in control and the third: Patients in control: ‘assume it’s possible’.