Outcomes measurement tool

We have divided the Outcomes Framework into nine types of initiative:

Community engagement and outreach
Initiatives to build trust with communities and promote engagement with health and care services.

Pathway reform or improvement
Initiatives that seek to redesign an existing clinical pathway.

Scale-up of pilot or existing initiative
Initiatives to spread and scale a well-evidenced initiative to a larger geographical area or increase the number of users.

Culture improvement
Initiatives to improve staff retention, development and happiness at work (or other components in NHS staff survey).

Admission avoidance
Initiatives to prevent people from being admitted to (usually acute) care, usually by providing alternative, less intensive modes of care in the community.

Discharge support
Initiatives to discharge patients as early as possible from (usually acute) care into less intensive care modalities e.g. in the community.

Skills building
Initiatives to build skills within staff, patients or populations

Prevention and early intervention
Initiatives to prevent development of disease or adverse events by detecting risk factors or disease as early as possible and offering treatment if needed and appropriate.

New pilot / (Re) Commissioning or OTHER initiative type
If you are launching a new pilot, (re)commissioning a service or initiative or evaluating any other type of initiative please check these ideas of what to measure.

Select ‘New pilot/(Re)Commissioning or OTHER initiative type’.

You might want to think about it in terms of how many people are receiving the initiative you are evaluating, where:

• Less than 50 people = Small
• 51-500 people = Medium
• >500 people = Large

If you browse through the different initiative types, you will see some include recommended metrics  for all five pillars while others don’t. This is because some pillars of the Outcome Framework are more relevant to certain initiative types than others.

For instance, initiatives focusing on ‘Culture Improvement’ (eg staff) don’t need to capture anything on patient outcomes or experiences. However, if you feel like your culture improvement initiative will lead to patient benefits, then do capture those.

We would expect you to have metrics in your initiative logic model that are not captured in this framework – but are still important. We encourage you to include them in your evaluation. Remember, this is more a ‘minimum set’ of metrics rather than everything you might need.

That’s fine – your metrics need to be relevant to your specific initiative. Note that we’ve also mentioned in the framework you can capture metrics that are specific to populations of interest – such as Core20 populations – to address this point.

First, have you considered all possible costs you could capture? These could be:

• Fixed costs – These could relate to buildings and infrastructure (renting a room for training sessions for instance) or software licenses (such as a fixed payment for access to a screening tool).
• Variable costs – These can cover, for instance, the number of staff hired or consumables used.

If you still don’t think you are spending any money directly, are there indirect costs or non-monetary ways to capture resource use?

• The most basic of these is staff time ie you could capture the number of hours/days of staff time used to deliver your initiative. This can be done by band or by asking staff to estimate how many hours a week they are spending on your initiative. For instance, staff hours by AfC Band can then be converted into pound sterling if needed and included in your evaluation.