5.9.2 Evaluating the outcomes of person centred intermediate care interventions (272)

Valerie Thomas, Tutor - Health Policy, School of Health Science, Swansea University, Swansea, Wales, United Kingdom

Abstract:

Background:

The function of intermediate care is transition from hospital to home and from dependence to independence (Steiner 1997. Governments have high expectations of services to improve quality of life (QoL) and to solve system pressures within acute hospitals. The latter is relatively easy to measure through length of stay and readmission rates. Measurement of health services must be based on a specific conceptual approach (Bowling 1997) and the interaction of factors and conceptual difficulties present when measuring independence and QoL in intermediate care as it is a model that is characterised by diversity and difference.

Aim:

The aim is to explore the how staff working in community based intermediate care teams measure outcomes.

Methods:

The paper draws on results from a Doctoral study (data collection from mid 2006 to mid 2007). Methods included 2 focus groups (n=6, n=10) and observations with IC teams (n=6), face to face interviews with referrers (n=17) and an evaluation of the outcome measures. Data were coded and analysed within and across data sets to identify themes.

Results:

Person centred care is central to the teams but individual choices may decrease outcome scores, for example, assuming that people with a lower score on mobility have a lower quality of life than someone with a higher score. Intermediate care is facilitated by integrated working and the varied functions of members within the team are not acknowledged by existing measurement tools.

Discussion:

The need to describe and measure the effectiveness of services is inevitable. People involved in developing these services to need use an appropriate range of tools which have the sensitivity and specificity to discern and evaluate the inputs and outcomes of interventions (McDowell and Newell 1996). Conclusion: These results contribute to knowledge on outcome measures within intermediate care and will inform future debates.

Biography:

I work as a tutor in health policy in the Centre for Health Economics and Policy Studies in the School of Health Science, Swansea University. I qualified as a staff nurse in 1986 and for almost 20 years worked as a ward manager, nurse manager, directorate manager and senior manager in in the NHS and Social Services in England and Wales. I am an elected member of the Royal College of Nursing Forum for Nurses Working with Older People. I have enjoyed being involved in research projects on assessment tools, older people's journeys in acute hospitals and a range of service evaluations. I am currently completing my Doctorate exploring the development of Intermediate Care.