Three years ago we wrote this blog post what an outcome is. It came from our experience of talking to organisations and being acutely aware that, in many cases, the distinction between impact and activity wasn’t entirely clear. We thought it might be useful to revisit this attempt to define outcomes and look at the different types of outcomes that organisations use to demonstrate impact. Examining the types of outcome you collect is useful because those outcomes frequently influence the way that you design and deliver a service.
In looking at outcomes this will focus on individual outcomes rather than systemic outcomes. If you are interested in the difference in how outcomes can be measured for the individual rather than the system the individual finds themselves in then we have another blog post here that might be useful.
In the work, we have done on outcomes, we have identified three basic outcome types that are used in face to face services:-
- Progressive personal outcomes
- Binary status outcomes
- Personal goals
Each of these are valid methods for measuring impact but, as you would expect, each has strengths and weaknesses. We’ll look at the pros and cons of each.
Progressive Personal Outcomes
These are by far the most prevalent form of outcome measurement in the health and care sector. The best example being the well-established Outcome Star system. The system works by the individual scoring themselves in areas of their life that are relevant to the service provider. At key points in the intervention, the individual scores themselves again and the progress from one score to another is deemed the outcome. This a simplified explanation of the process but hopefully it sets out that it is a collaborative approach between the individual and the service.
In applying this approach there is the issue that it is subjective. As it is based on the individual’s perception of any change, that makes a comparison between people very difficult. Comparison, in impact, between different services also becomes speculative at best. With this type of measurement attributing an outcome to an intervention is difficult. People are complex and the changes in their life can rarely be attributed to the influence of an individual service. Knowing that someone perceives an improvement in their life situation is useful to know, but how do you relate that to the service you have provided?
Binary Status Outcomes
These outcomes look at individual protective factors, or issues, and measures that are present in a person’s life. The outcomes are achieved as the issues are resolved. Although less collaborative than the progressive personal outcomes approach they too require individuals to make an assessment of issues that exist in their lives and whether or not those issues are resolved. For example, if someone asks for help and support with giving up smoking the outcome is achieved when the person is no longer a smoker. This is the approach we take in our Risk Tracker system because it is an objective measure of both the individual and the service. This means they can be compared.
Equally, there is an issue of attribution, can a service that the issues have been resolved by them? In many cases, it is difficult to prove that there is a direct line of causality between an intervention and an outcome but being aware of the work that has been done to address an issue does increase confidence in the relationship. This model of outcome measurement directly links the Government National Outcome Frameworks which means it is rooted in a consistent approach between services.
The process of setting personal goals, and measuring the success in achieving them, is one of the least used, yet most powerful, measures of outcomes. Agreeing with an individual what they want to achieve, as part of their interaction with a service, and measuring whether those goals are achieved is an accurate representation of impact. These can be easily attributed to the service which provides good authority for the quality of the intervention.
A key weakness of this method is the subjective nature of goals. Goals set by individuals might provide an equal level of value to the person but are not necessarily comparable in terms of the inputs that need are needed to achieve those goals.
In an ideal world, a combination of these approaches would give an accurate summary of impact. Realistically the process of collecting all three is likely to impact on the effectiveness of the intervention. All organisations should consider what they believe they achieve with the people they work with and what would be the best outcome approach to demonstrate that impact.
If you are in the process of thinking about how you demonstrate the impact of your organisation we would be happy to help and support you in that thinking. Please get in touch via comments below or our email firstname.lastname@example.org