Outcomes Based Practice – Underpinning Theories and Principles Introduction
If the emphasis that the Care Quality Commission (CQC) has placed on the importance of outcomes is anything to go by, providers of care and support services in today’s care environment may imperil themselves if they do not work to achieve and demonstrate desirable outcomes with and for the people they support in whatever capacity. This much is evident in the way that the CQC in its publication (Guidance about compliance - Essential Standards of Quality and Safety, 2010) highlights what the expected outcomes are to be and then identifies the specific regulations that would lead to meeting the outcome. It is very clear that outcomes are very important. What is perhaps not so clear is determining what outcomes are. Many professionals especially frontline staff who deliver the specific intervention that is supposed to demonstrate the achievement of desired outcomes do not appear to clear as to what this sometimes nebulous term requires of them. Although many careworkers do regularly deliver support that is geared towards achieving outcomes, and although they witness regularly the outcomes of their input into the lives of the people they support, ask the average careworker to demonstrate the outcomes they have helped a person achieve, and they seem to think that they are expected to produce a thesis on the subject, searching for ‘professional’ sounding words and phrases in the attempt. A succinct definition of the term is essential to demystify these expected ‘outcomes’, so that care professionals are clear about what it is that they do and how those things that they do, if they do them well, inevitably result in an outcome. There are myriad definitions of the word, ‘outcomes’, out of which I have picked the one Alan Barr gives in his paper to the Scottish Development Alliance Conference (3 June 2005). Barr defines outcomes as: ‘...the specification of the differences that are intended to result from a given activity.’ (p.1)
He goes on to say that outcomes must be distinguished from outputs, these being the actions that we take or services we deliver; the specific things we do that are in themselves the means of achieving outcomes. If these outputs are done correctly they result in a recognisable change or benefit. This change or benefit, no matter how small, which emerges as a result of some output, is an outcome. An example would be a person who is encouraged to have a shower following a complaint from others with whom they attend day centre that they had odious body odour, which led the others not to want to associate with that person. If that person agreed to shower and this resulted in the complainants finding them less offensive, the output is the act of showering, but the outcome is an improved social network and greater self esteem. Underpinning Theories and Principles
So, how did we get here? Time was when the benefits derived by a person using care services were measured in direct comparison to the tasks that the careworker had completed. In the above example the benefits accrued from the intervention would be measured in how much time and other resource went into the shower, but the underlying benefit – that of attaining self esteem and social inclusion - went largely unmeasured. My research into this essay has hot revealed any direct correlation between the need to give effect to Maslow’s theory on the hierarchy of human needs, and the development of outcomes theories, but I posit that there is a connection, and that while it may not be a direct product of Maslow’s theory, the desire to help individuals achieve desirable outcomes certainly emphasises that people who use services also have needs that Maslow identified. Although Maslow only focussed his attention on what he called exceptional people, I do feel that those needs are so fundamental to every human being that it is only right to expect that everyone will at least have...
Bibliography: Barr, A. (2005). OUTCOME BASED COMMUNITY DEVELOPMENT PRACTICE – HOW DID WE GET HERE AND DOES IT MATTER? Scottish Community Development Alliance Conference, (p. 1).
Care Quality Commission. (2010). Guidance about compliance - Essential Standards of Quality and Safety. London.
Lewis, J. a. (2001). REDISCOVERING THE COMMUNITY CARE APPROACH. Referenced in 'An Outcome-Based Approach to Domiciliary Care ', (Sawyer, L, 2005) .
Maslow, Abraham. (1954). Motivation and Personality. New York: Harper and Row New York.
Qureshi, H. P. (1998). OUTCOMES IN COMMUNITY CARE PRACTICE. OVERVIEW: OUTCOMES OF SOCIAL CARE FOR OLDER PEOPLE AND CARERS. York: University of York.
[ 6 ]. [ (Qureshi, 1998) ]
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[ 8 ]. [ (Lewis, 2001) ]
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