Focusing on the lived experience
Quereshi's Work on Outcome Domains provides a useful framework to understand some of our ToC outcomes. This framework categorizes outcomes into three distinct domains: process outcomes, change outcomes, and maintenance outcomes. Each domain addresses different aspects of care delivery and user experience, ensuring a holistic assessment of service quality and impact.
Process outcomes focus on the lived experiences of service users and the quality of service delivery. These outcomes emphasize the nature of interactions and relationships within the service and between the service and the local community. Key aspects include the quality of relationships and interactions, user experience, and compatibility with cultural preferences. Process outcomes highlight how services are delivered, ensuring that users feel valued, respected, and in control. They stress the importance of respectful, individualized, and culturally sensitive interactions, which are crucial determinants of positive user satisfaction and overall service effectiveness.
Change outcomes are primarily concerned with measurable improvements in the physical, mental, or emotional functioning of service users. These outcomes assess the effectiveness of a service in enhancing health and well-being, with a strong focus on tangible improvements in physical functioning, such as mobility, strength, and endurance. Additionally, change outcomes consider enhancements in mental clarity, emotional stability, and overall psychological well-being. This domain is crucial for understanding the direct impact of care services on the health status of users.
Maintenance outcomes aim to prevent or delay the deterioration of health, well-being, and quality of life, particularly for older adults. These outcomes focus on sustaining users' current state of health and independence by meeting basic care needs, maintaining a clean and safe living environment, and facilitating social interactions. Key aspects include supporting daily living activities, keeping users active and alert, and ensuring that users can live independently for as long as possible. Maintenance outcomes are highly valued by older adults who prioritize maintaining their quality of life through continued independence and social connections. Home care and day services play a crucial role in achieving these outcomes, enabling individuals to remain in their homes and communities.
Each outcome domain plays a critical role in evaluating and improving the effectiveness of care services, ensuring that they meet the diverse needs of users and enhance their overall well-being. By situating these care service outcomes within Quereshi's framework, we can see how each outcome contributes to the overall goals of improving, maintaining, and delivering high-quality care. These outcomes collectively support a holistic approach to care that values the lived experiences of users, fosters positive change, and sustains quality of life.
Process Outcomes in our Theory of Change
Our Theory of Change (ToC) is primarily oriented towards process outcomes within Quereshi's Outcomes Framework. This focus is evident in our emphasis on enhancing the quality of interactions and relationships within the care service, promoting user experience, and ensuring that services are delivered in a way that makes individuals feel valued and respected. Key aspects of our ToC include ensuring care workers feel secure and supported in their roles, fostering autonomy and collaboration in care planning, and creating more social and engaging environments for users. By prioritizing these elements, our ToC aims to cultivate a service environment where users have control over their care, experience lasting and trusting relationships, and benefit from flexible, personalized support. These objectives align closely with the fundamental determinants of positive process outcomes, ensuring that the subjective experiences of all those involved in the care service are postive. Our ToC suggests that we must focus on measuring the lived experience of the service in terms of the quality of interactions and relationships.
References
Qureshi, H., & Nicholas, E. (2001). A New Conception of Social Care Outcomes and Its Practical Use in Assessment with Older People. Research, Policy and Planning, 19(2), 11-26.
Qureshi, H., Patmore, C., Nicholas, E., & Bamford, C. (1998). Outcomes in Social Care Practice: Developing an Outcome Focus in Care Management and User Surveys. York: Social Policy Research Unit, University of York.
Last updated
Was this helpful?