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Improving personalised care, through the development of a service evaluation tool to assess, understand, and monitor delivery

Improving personalised care, through the development of a service evaluation tool to assess, understand, and monitor delivery
Improving personalised care, through the development of a service evaluation tool to assess, understand, and monitor delivery
Systematically implementing personalised care has far reaching benefits to individuals, communities and health and social care systems. If done well, personalised care can result in better health outcomes and experiences, more efficient use of health services and reduced health inequalities. Despite these known benefits, implementation of personalised care has been slow. Evaluation is an important step towards achieving the ambition of universally delivered personalised care. There are currently few comprehensive assessments or tools that are designed to understand the implementation of personalised care at a service or system level, or the cultural, practical and behavioural factors influencing this. The aim of this paper is to describe the development and testing of a system-wide evaluation tool. The tool offers a process through which healthcare systems can better understand the current delivery of personalised care and the factors influencing this. With a focus on implementation, the development of the tool was informed by the Consolidated Framework for Implementation Research, and its content is structured using behaviour change theory (COM-B Theory of Behaviour Change Model). The tool consists of four mirrored surveys, which were developed using an iterative exploratory design. This included a series of testing cycles, in which its structure and content were continually refined. To date, it has been used by 24 clinical services, involving 397 service users, 313 front-line practitioners, 73 service managers and 40 commissioners. These services have used the evaluation process to initiate quality improvement, targeted at one of the more aspects of personalised care. The use of the COM-B model increases the likelihood of those improvements being sustained, through identification of the core factors that enable or limit personalised care behaviours among healthcare staff. We have shown this process to be applicable in a wide range of settings, thus it potentially has broad applicability as a tool for cultural change and quality improvement. The next stage of this work will focus on implementation and evaluation, to fully understand if and how the tool can be used to drive improvements in personalised care delivery.
Health policy, Patient-centred care, Quality improvement, Quality measurement
Johnson, Louise
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Kirk, Hayden
b7da6bcf-879d-4cdb-80ac-6d7bbd4864f5
Clark, Beth
bc71de33-092b-467e-806a-df2ff4e1175c
Royse, Carolyn
454ae1ff-1576-4789-b50b-a86ce0a5c83f
Heath, Stephanie
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Adams, Carl
b30422e9-ab71-4ed7-90f4-1604edd7eb56
Portillo Vega, Maria Carmen
f913b5c5-b949-48f2-b1d0-eb7505484d5c
Johnson, Louise
e3990718-f3f9-417e-a122-f4bdc09ea9fc
Kirk, Hayden
b7da6bcf-879d-4cdb-80ac-6d7bbd4864f5
Clark, Beth
bc71de33-092b-467e-806a-df2ff4e1175c
Royse, Carolyn
454ae1ff-1576-4789-b50b-a86ce0a5c83f
Heath, Stephanie
02d9e4f7-2387-4c91-adc7-d932833eaad9
Adams, Carl
b30422e9-ab71-4ed7-90f4-1604edd7eb56
Portillo Vega, Maria Carmen
f913b5c5-b949-48f2-b1d0-eb7505484d5c

Johnson, Louise, Kirk, Hayden, Clark, Beth, Royse, Carolyn, Heath, Stephanie, Adams, Carl and Portillo Vega, Maria Carmen (2023) Improving personalised care, through the development of a service evaluation tool to assess, understand, and monitor delivery. BMJ Open Quality, 12 (3), [e002324]. (doi:10.1136/bmjoq-2023-002324).

Record type: Article

Abstract

Systematically implementing personalised care has far reaching benefits to individuals, communities and health and social care systems. If done well, personalised care can result in better health outcomes and experiences, more efficient use of health services and reduced health inequalities. Despite these known benefits, implementation of personalised care has been slow. Evaluation is an important step towards achieving the ambition of universally delivered personalised care. There are currently few comprehensive assessments or tools that are designed to understand the implementation of personalised care at a service or system level, or the cultural, practical and behavioural factors influencing this. The aim of this paper is to describe the development and testing of a system-wide evaluation tool. The tool offers a process through which healthcare systems can better understand the current delivery of personalised care and the factors influencing this. With a focus on implementation, the development of the tool was informed by the Consolidated Framework for Implementation Research, and its content is structured using behaviour change theory (COM-B Theory of Behaviour Change Model). The tool consists of four mirrored surveys, which were developed using an iterative exploratory design. This included a series of testing cycles, in which its structure and content were continually refined. To date, it has been used by 24 clinical services, involving 397 service users, 313 front-line practitioners, 73 service managers and 40 commissioners. These services have used the evaluation process to initiate quality improvement, targeted at one of the more aspects of personalised care. The use of the COM-B model increases the likelihood of those improvements being sustained, through identification of the core factors that enable or limit personalised care behaviours among healthcare staff. We have shown this process to be applicable in a wide range of settings, thus it potentially has broad applicability as a tool for cultural change and quality improvement. The next stage of this work will focus on implementation and evaluation, to fully understand if and how the tool can be used to drive improvements in personalised care delivery.

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Accepted/In Press date: 18 August 2023
e-pub ahead of print date: 5 September 2023
Published date: 5 September 2023
Additional Information: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: Health policy, Patient-centred care, Quality improvement, Quality measurement

Identifiers

Local EPrints ID: 481434
URI: http://eprints.soton.ac.uk/id/eprint/481434
PURE UUID: 793186b7-16ad-4eac-81c8-ba2b23cf2ebd
ORCID for Louise Johnson: ORCID iD orcid.org/0000-0001-9445-0069
ORCID for Beth Clark: ORCID iD orcid.org/0000-0003-4493-166X
ORCID for Maria Carmen Portillo Vega: ORCID iD orcid.org/0000-0003-1583-6612

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Date deposited: 29 Aug 2023 16:43
Last modified: 18 May 2024 04:01

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Contributors

Author: Louise Johnson ORCID iD
Author: Hayden Kirk
Author: Beth Clark ORCID iD
Author: Carolyn Royse
Author: Stephanie Heath
Author: Carl Adams

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