Transcript Applying Outcome Thinking

Developing Local
Outcomes-Based Investors
for GOWM
OUTCOME FRAMEWORKS
The Centre for Public Innovation
50 harmful drinkers access our
service where two CBT trained
counsellors are available to
work with them
The two counsellors deliver up
to six sessions of CBT therapy
for each of the 50 hazardous
drinkers who presented
Of the 50 hazardous drinkers who
presented to our service, 35
completed the programme and 20
reported a reduction in alcohol
consumption to no more than
sensible levels.
We checked in with people at three
months and 12 had maintained this
change
PROCESS AND
OUTCOMES
INPUTS
• Who uses the service - client demographics
or the resources applied to the service
OUTPUTS
• What does the service do for people?
OUTCOMES
• Who (and how many) benefit from the
service intervention?
OUTCOME
• “West Midlands region alcohol commissioners will have the skills
to adopt an outcomes-based commissioning approach to alcohol
investment.”.
PERFORMANCE TARGETS
Participants will:
• Report understanding of outcome-based commissioning
• Be able to describe how it differs from current practice
• Have explored the changes needed in purchasing processes and
practical steps for implementing the new regime
• Learned how to apply outcome-based commissioning to alcohol
interventions.
OUTCOME
• “West Midlands region alcohol commissioners will have adopted
an outcomes-based commissioning approach to alcohol
investment, increased provider performance and return on
investment.”.
PERFORMANCE TARGETS
Participants will:
• Report understanding of outcome-based commissioning
• Be able to describe how it differs from current practice
• Have explored the changes needed in purchasing processes and
practical steps for implementing the new regime
• Learned how to apply outcome-based commissioning to alcohol
interventions.
• Committed to start applying outcome approaches
Why Outcomes?
“Perfection of means and confusion of ends
seems to characterise our age” - Albert Einstein
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Successful organisations set ambitious targets
and are clear and specific about how they define
success in customer or community terms
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The outcomes drive success; not the process
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Outcome frameworks offer a results and
learning approach to achieving performance
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Answers the question….SO WHAT?
Outcomes
End state or visions
Specific changes in behaviour, condition
and / or satisfaction
Gains, results and impacts
For our Communities
What makes successful
commissioning?
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Whole market perspective
Understanding of local needs
Aligning resources to meet needs
Knowledge of portfolio
Developing services
Managing performance
On-going
The Institute of Public Care’s (IPC) framework for joint commissioning & purchasing
of public care services. http://www.cat.csip.org.uk/_library/eBook/Chap1FRichardson.pdf
GETTING TO OUTCOMES
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What are we trying to change?
How will we know if we get there?
Identify the impact or change area
Define a way to verify the change
Determine degree of change for
success
Commissioning outcomes
Investing in
1. What are the results we are buying?
2. What are the chances of success?
3. Is it the best use of our money?
Investors need to know from providers:
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Who are your customers and how many do you plan to
serve?
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What are your performance targets for those customers
and how will you know if you reach them?
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What are the core features of your product or service?
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Who are the people delivering the product or service?
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How much will it cost to achieve the performance targets?
Investor Questions
Provider response
What results are we
buying?
Customers
Who and how many?
Performance targets
Change area and
strength?
What are the chances
for success?
Service
Key people
Milestones and pathways
Innovations
Is this the best use of
resources?
Financial projections
Key Terms and Concepts
An end state or vision in a given
area. In Outcome Based
Commissioning this statement is
in the domain of the investor.
Investors
OUTCOME
PERFORMANCE
TARGET
MILESTONES
Specific changes in behaviour,
condition that define project /
service achievement.
Performance targets are defined
by the providers.
Providers
A verifiable, critical point in a
project that participants must
reach to ensure that a project is
on course to achieve its
performance target.
Alignment for results
--------------------------------Strategy
National
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High Level Outcomes
Key Performance Indicators
Regional / local
Investor outcome-based Performance Targets
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Local / providers
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Service Performance Targets and Measures
The tools of outcome management
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Target Plan
Performance Target
Milestones
Funnels
Tracking
Verification methods
SERVICE CLARITY
Core assumptions
• People, not written plans or even money,
get things done
• Planning and doing are inseparable
• A partnership of investor and provider
greatly enables success
• Success means achieving results
• Outcome thinking encourages innovation
and learning
Key components of the Specification
 Who are the customers for the programme?
 How many will be served in a year?
 What are the core features or interventions
offered?
 What are the unique features of the service?
 Who are the key internal people?
 Who are the key external people or partners?
 What are the milestones?
 What defines success (performance target)?
 Tracking and verification
Outcome journey
vision
Bridge / Opportunity
Finish
M2
Barrier
M1
Start
Your vehicle
M3
Milestone Funnel
Week 1
Week 4
Week 8
Week 10
Week 12
Calls or visits makes an appt
100
Attend 1st session and agree
personal goals
50
Remains engaged at week 4 and can
describe 4 alc related harms
40
Remains engaged at week 8 and is
alc free for 2 days pw
30
Engaged & signed up
to 1 diversionary activity 25
Planned closure, alc free 17
Performance Target: 10 harmful or dependent drinkers will complete the
programme, have remained alcohol free or drinking within low risk limits
for three months after the programme ends.
Performance management tools
Performance review cycle
Performance report
Measured against standard in SLA
Specialist care
Numbers of people in service
Level of alcohol intake (at regular points in care)
Length of time in service (<3 months, <3>6months, >6months)
Did not attend rates DNA
AUDIT/FAST score pre and post treatment
User views of services
Primary care (Aggregate from Practices)
Number of new registrants subject to AUDIT/FAST
Number of brief advice given
Numbers of referrals to specialist services
Acute setting (Aggregate from A&E, fracture clinic)
Number of new registrants subject to AUDIT/FAST
Number of brief advice given
Numbers of referrals to specialist services
User views of services
q1
q2
q3
q4
Negotiate objectives
and development plan
for year. Qualitative and
quantitative
Quarter 4 review, and
feed into next SLA
Quarter 1 review
Agree and use
escalation process if
needed
Quarter 3 review, feed
into thinking on future
market shape
Quarter 2 review and
publish
What works for alcohol-related harm?
Who has a good performance review
process to share?
METHODS OF VERIFICATION
Tools
Techniques
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Questionnaires
Measures
Tests
etc
Interviews
Observation
Self report
Pre and Post
Follow-up
Artefacts