monitoring of interventions for people with substance abuse and addiction problems - how do we know...
TRANSCRIPT
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Monitoring of interventions for people with substanceabuse and addiction problems- how do we know what works?
[email protected] 761-30 77 65
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Why monitor outcomes from interventions?
Several reasons from different perspectives:
• legislation and regulations from the Swedish board of health and welfare
• ”open comparisons” and national inspection show that there are problems with client participation and the monitoring of interventions.
• better care for people who have dependency problems
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”…the overall purpose with social work is to maintain a good or improve an inadequate quality of life for
those people we are trying to help…”
Source: Blom, B & Morén, S (2011) Utvärdering i socialt arbete –Utgångspunkter, modeller och användning
“…clients’ subjective experiences of welfare and wellbeing are a central source of knowledge for those who deliver and manage social work…”
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“Local monitoring is a necessary part of an evidence-based programme but also for social workers wanting to work rationally and goal-focused way without calling their work evidence-based”
Source: Bergmark, A, Bergmark, Å, & Lindström, A(2011) Evidensbaserat socialt arbete, Teori, kritik, praktik
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Mandate from the city council:
• Good quality evaluation and forward planning should involve those people who use the city’s services, in order to increase service-user influence and contribute to an improved quality of service
• It is very important that we all continue to improve analyses and monitoring within our respective organisations
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• Care and treatment of adults = 160 million Swedish kronor (ca 17.7 million EUR)
Costs for the city of Gothenburg
Benefits for the clients?
What are the outcomes?
Net Costs 2012
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Is a department effective if it:
• follows the rule of law• is accessible• treats clients in a polite and respectful way• has low/high costs per user• has procedures for dealing with complaints• is based on respect for people’s integrity and their
right to make their own decisions• has a high proportions of outpatient care• has well-trained staff• has agreements with other organisations
Quality (indicators) in social services
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Performance
Structural
Process
Outcomes from the client’s perspective
Activities in the organisation
Predetermined structural conditions
The aim is that ”open comparisons” will focus much more on performance indicators
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Reversed perspective based on outcomes
Performance
Structural
Process
To measure results from the user’s perspective
To measure processes and conditions (activities)
To measure predetermined structures (funding, staff etc.)
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Uppföljning av Insatser för Vuxna med missbruks eller beroende-problematik.
Monitoring of Interventions for Adults with abuse or dependency related problems
UIV
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• To increase client involvement and to give the social worker a structure for the interview at the end of the intervention
• To increase knowledge about the effects of interventions
• Feedback to policy makers on the effectiveness of the organisation
• Compare outcomes with other municipalities
• To show which healthcare providers have positively rated results for a particular type of intervention
• To allow setting up of goals that are related to benefit to the user
• Contribute to increased quality and the better utilisation of economic resources
The aim of UIV
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How we do this in practice
• All social workers/social welfare officers interview their clients at the end of the intervention
• Questions are based on a structured method with all clients being asked the same questions
Questions:
• Background information (age, sex, care provider etc.)• Which intervention the client received• The client’s evaluation of the intervention• The social worker’s evaluation of the intervention
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• Inpatient care and treatment
• Outpatient care
• Foster care for adults
Type of interventions
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National Development Council
• to ensure development and long-term maintenance of the model
• representatives from regional Research and Development units, universities and social workers/managers
• for more information see: www.nuso.se
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Monitoring outcomes should guide our actions rather than plans that have no connection with benefit to the client
Monitoring provide a basis for dialogue – dialogue creates possibilities for development