Using results to continuously improve integrated care

The value of monitoring and evaluation

Ultimately, the value of monitoring and evaluation activity rests on how the evidence is used to do the following.

Using results to drive continuous improvement is an ongoing challenge that requires continuous commitment and effort across the system. This section sets out a few examples of how to use evidence to inform change.

Whole-system dashboards

Across health and care, there are numerous different quality, performance and finance measures, systems and cultures. In some areas, key measures have been pulled together into an integrated ‘dashboard’ which can provide an overview on progress and may replace some of the current reporting arrangements. Consider aligning measures to cover the six domains to assess integrated care. An integrated dashboard can help provide a whole-system view at a glance and inform tactical and strategic decisions to accelerate improvement.

A dashboard:

Establishing a learning culture

The NHS and local authorities have a long tradition of innovation and improvement. Over recent years, this has accelerated with a range of pilots, innovation test-beds, new models of care and new ways of working. There is a growing evidence base about what works (local, regional, national and internal), and the challenge to localities is to make use of this evidence to learn and improve on an ongoing basis.

It is important to build a process for continuous learning, training, evaluation and development. This means:

Action learning sets

Action learning sets can help build a learning culture. They are defined as a ‘continuous process of learning and reflection, supported by colleagues, with an intention of getting things done’ (see McGill and Beauty: Action learning – a practitioners’ guide). Individuals work on real work issues and openly reflect on their experiences with a view to taking subsequent action. One of the fundamental aims of action learning is to help participants develop the skills for, and make time for, active reflection to solve their own problems. Action learning sets can be linked with coaching/mentoring. Participants are recruited to a ‘set’ and meet regularly (every six to eight weeks) to sustain momentum and commitment. Less often than this and a group can often repeat the cycle of trust formation and not get any further.

There are three key benefits of action learning sets:

Reflect, measure and learn rapidly about what is and is not working to help implementation become more successful.

Improving quality in the English NHS – A strategy for action

Checklist: using results to continuously improve

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How to... understand and measure impact of integrated care
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