Meaningful and measurable: developing approaches to the analysis and use of information on personal outcomes within health and social care

英国和其他国家的政策和实践都致力于改善使用服务和无偿护理人员的人的生活。在过去的五至十年中，人们特别关注的是将卫生和社会保健系统从只关注自身的投入、过程和产出，转向更加突出地关注使用服务的人和无薪照护者的个人结果。在这种情况下，个人成果一词用于指服务和支助对个人生活的影响和最终结果，更简单地说，指对人们重要的东西。拟议的项目建立在一个为期七年的知识交流和服务改进计划的基础上，该计划由两位申请人（艾尔萨·库克博士和艾玛·米勒博士）领导，由苏格兰联合改进小组资助。该项目被称为“谈话要点”，与130多个组织合作，以支持以结果为重点的实践的发展。“谈话要点”方案的一项重要发现是，卫生和社会保健组织在定性和定量分析个人成果信息方面的能力和技能有限，这对注重成果的有效项目构成了重大障碍。此外，绩效文化的优势加剧了这个问题，这些文化优先考虑信息的一致性、可比性和可测量性，而不是意义。在过去的一年里，15个合作伙伴组织共同努力，制定了这项由ESRC资助的提案。合作组织都参与了“谈话要点”计划，包括以下学术、实践和国家利益相关者合作伙伴：爱丁堡大学（主办机构）、斯特拉斯克莱德大学、斯旺西安格斯大学理事会、布里真德郡自治议会、爱丁堡市议会、东伦弗鲁郡卫生和保健伙伴关系、Moray卫生和社会保健伙伴关系、半阴影、斯特林理事会、联合改进小组，社区护理基准网络，联盟，社会服务检查机构。拟议的项目涉及合作行动研究和知识交流两个要素。具体而言，学术团队将支持每个实践合作伙伴参与一个行动研究项目，重点是分析和使用通过其组织内的评估和审查过程例行收集的个人成果数据。这些项目之间的协调与合作将主要通过举办三次为期两天的“数据务静会”来实现，在这些务静会中，项目合作伙伴将共同努力，发展能力和技能，交流知识，并反思这一过程。国家利益攸关方伙伴的贡献将确保向更广泛的保健和社会保健组织有效传播和执行该项目的调查结果。这将通过支持一系列知识交流过程来实现，包括举办活动、分发材料，以及员工与其他没有直接参与项目的组织合作，将研究结果应用到他们自己的实践中。这些合作伙伴都积极参与制定政策，与他们接触将确保项目结果影响国家政策，特别是影响国家成果执行情况报告框架的制定。在这些方面，预计拟议的项目不仅将为合作伙伴和提供者组织带来重大利益，而且将为更广泛的卫生和社会保健系统带来重大利益。项目的短期影响将通过贡献分析过程进行系统评价。这项贡献分析的结果和整个项目将广泛传播，包括传播给学术读者。

Policy and practice across the UK and beyond is committed to improving the lives of people who use services and unpaid carers. Over the past five to ten years there has been a particular concern to shift health and social care systems away from an exclusive focus on their own inputs, processes and outputs to give a more prominent focus to personal outcomes for people using services and unpaid carers. In this context the term personal outcomes is used to refer to both the impact and end results of services and supports on a persons life and more simply, what matters to people. The proposed project builds on a seven year programme of knowledge exchange and service improvement that has been led by two of the applicants (Dr Ailsa Cook and Dr Emma Miller) and funded by the Joint Improvement Team in Scotland. This programme, known as Talking Points, has involved work with more than 130 organisations to support the development of outcomes focussed practice. A key finding emerging from the Talking Points programme is that limited capacity and skills in the analysis of qualitative and quantitative personal outcomes information within health and social care organisations constitutes a significant barrier to effective outcomes focussed project. Furthermore, this issue is exacerbated by the predominance of performance cultures that prioritise consistency, comparability and measurability of information over meaning. Over the past year 15 partner organisations have worked together to develop this proposal for funding from the ESRC. The partner organisations have all been involved in the Talking Points programme and include the following academic, practice and national stakeholder partners:University of Edinburgh (host institution), University of Strathclyde, University of SwanseaAngus Council, Bridgend County Borough Council, City of Edinburgh Council, East renfrewshire Health and Care Partnership, Moray Health and Social Care Partnership, Penumbra, Stirling Council, VOCAL (Voice of Carers Across Lothian)Joint Improvement Team, Community Care Benchmarking Network, The ALLIANCE, Social Services Inspection Agency. The proposed project involves both collaborative action research and knowledge exchange elements. Specifically the academic team will support each of the practice partners to engage in an action research project focussed on the analysis and use of personal outcomes data routinely collected through assessment and review processes within their organisations. Co-ordination and collaboration between these projects will be primarily achieved through the convention of three 'data retreats' two day workshops where project partners work together to develop capacity and skills, exchange knowledge and reflect on the process. The contribution of national stakeholder partners will ensure that the findings of this project are effectively disseminated to and implemented within a wider constituency of health and social care organisations. This will be achieved through support for a range of knowledge exchange processes, including events, dissemination of materials and staff time to work with other organisations not directly involved in the project to implement the findings in their own practice. Engagement with these partners, all of whom are actively involved in shaping policy, will ensure that the project findings influence national policy, in particular in relation to the development of national outcome performance reporting frameworks. In these ways it is anticipated that the proposed project will bring significant benefits not only to partner and provider organisations, but to the wider health and social care system. The short term impacts of the project will be systematically evaluated through a process of contribution analysis. Findings from this contribution analysis and the project as a whole will be widely disseminated, including to academic audiences.