The NSW Agency for Clinical Innovation (ACI) and IFIC Scotland held a joint workshop at the recent 1st Asia Pacific Conference on Integrated Care in Brisbane. The session titled ‘It’s All About Outcomes’ explored how to record and use personal outcomes to improve outcomes based consultations. The workshop also discussed how to use Patient Reported Outcome Measures (PROMs) and outcomes based conversations to enhance the experience and outcomes of care in different care settings and health systems.
Throughout the 90 minutes, the presenters described, compared and contrasted the complementary approaches used in Scotland and NSW that aim to promote the adoption of person centred care through collaborative care planning, enabling conversations and systematic use of patient reported outcomes. This included practical examples of practice delivered by a range of professionals across the care continuum.
The practical examples provided included describing the ACI’s Patient Reported Measures program and the importance of measuring what matters most to patients to improve their health outcomes and experiences of care across NSW. The use of Patient Reported Measures has enhanced the care delivery to people living with chronic and complex conditions; healthcare providers are using the results of the Patient Reported measures alongside their clinical assessment to have conversations, plan care and better understand the whole of person needs of people they are caring for.
In Scotland, work on embedding personal outcomes in health and social care practice builds on a ten year programme of academic research conducted at the universities of York and Glasgow, which considered both the inclusion of outcomes in assessment, care planning and review, and the use of outcomes information for improvement and performance purposes. Early efforts focused on re-orienting the conversation at the point of care and finding out how best to work together to achieve the outcomes identified through shared decision making. A key concern was to move away from an over-reliance on tools and tick boxes to restore staff communication and relationship building skills. The importance of leadership and culture was also recognised. The intention was always to not only give ‘voice’ to people using care services and unpaid carers, but also to ensure that those ‘voices’ influence action at different levels of decision making.
Implementing a personal outcomes approach has involved not just training for staff, but has meant changing conversations across the organisation so that personal outcomes are built into supervision, service planning, commissioning, monitoring and performance. In essence, a personal outcomes approach is about linking whole systems working with holistic practice.
Whilst the two program areas of work described during the workshop had different approaches and were from different countries; they had a very similar end point of improving patient outcomes and outcome based consultations. The audience also reflected on their personal experiences within their own programs of work and the challenges and enablers for trying to achieve this.
There was high engagement within the room of participants wanting to learn more about implementing an outcomes based approach, including Patient Reported Measures. The presenters acknowledged that it is an approach that takes times to build systemic change, starting small is key and to support the capability and capacity within healthcare systems is imperative to success.
Watch the full presentation here or download the slides here.
For more information, please contact:
ACI:Mel Tinsley , Manager, Health Outcomes Melissa.tinsley@health.nsw.gov.au
IFIC Scotland: Karen Barrie karen.barrie.1@blueyonder.co.uk