Transcript PowerPoint-presentation

Monitoring of interventions for people with substance
abuse and addiction problems
- how do we know what works?
[email protected]
0046 761-30 77 65
Why monitor outcomes from interventions?
Several reasons from different perspectives:
• legislation and regulations from the Swedish board
of health and welfare
• ”open comparisons” and national inspection show that there are
problems with client participation and the monitoring of interventions.
• better care for people who have dependency problems
“…clients’ subjective experiences of welfare and
wellbeing are a central source of knowledge for
those who deliver and manage social work…”
”…the overall purpose with social work is to maintain
a good or improve an inadequate quality of life for
those people we are trying to help…”
Source: Blom, B & Morén, S (2011) Utvärdering i socialt arbete –
Utgångspunkter, modeller och användning
“Local monitoring is a necessary part of an
evidence-based programme but also for social
workers wanting to work rationally and goalfocused way without calling their work
evidence-based”
Source: Bergmark, A, Bergmark, Å, & Lindström, A
(2011) Evidensbaserat socialt arbete, Teori, kritik, praktik
Mandate from the city council:
• Good quality evaluation and forward planning should involve
those people who use the city’s services, in order to increase
service-user influence and contribute to an improved quality of service
• It is very important that we all continue to improve analyses and
monitoring within our respective organisations
Costs for the city of Gothenburg
Net Costs 2012
• Care and treatment of adults = 160 million Swedish kronor
(ca 17.7 million EUR)
Benefits for the clients?
What are the outcomes?
Quality (indicators) in social services
Is a department effective if it:
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follows the rule of law
is accessible
treats clients in a polite and respectful way
has low/high costs per user
has procedures for dealing with complaints
is based on respect for people’s integrity and their
right to make their own decisions
has a high proportions of outpatient care
has well-trained staff
has agreements with other organisations
The aim is that ”open comparisons” will focus
much more on performance indicators
Performance
Process
Structural
Outcomes from the client’s perspective
Activities in the organisation
Predetermined structural conditions
Reversed perspective based on outcomes
Performance
To measure results from the user’s perspective
Process
To measure processes and conditions (activities)
Structural
To measure predetermined structures (funding, staff etc.)
UIV
Uppföljning av Insatser för Vuxna med missbruks eller beroendeproblematik.
Monitoring of Interventions for Adults with abuse or dependency
related problems
The aim of UIV
• To increase client involvement and to give the social worker a structure
for the interview at the end of the intervention
• To increase knowledge about the effects of interventions
• Feedback to policy makers on the effectiveness of the organisation
• Compare outcomes with other municipalities
• To show which healthcare providers have positively rated results for a
particular type of intervention
• To allow setting up of goals that are related to benefit to the user
• Contribute to increased quality and the better utilisation of economic
resources
How we do this in practice
• All social workers/social welfare officers interview
their clients at the end of the intervention
• Questions are based on a structured method with all
clients being asked the same questions
Questions:
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Background information (age, sex, care provider etc.)
Which intervention the client received
The client’s evaluation of the intervention
The social worker’s evaluation of the intervention
Type of interventions
• Inpatient care and treatment
• Outpatient care
• Foster care for adults
National Development Council
• to ensure development and long-term
maintenance of the model
• representatives from regional Research
and Development units, universities and
social workers/managers
• for more information see: www.nuso.se
Monitoring outcomes should
guide our actions rather than
plans that have no connection
with benefit to the client
Monitoring provide a basis for dialogue – dialogue creates possibilities for development