Implementing Telecare
Establish performance measures and baselines

As already established in Section 3.3, from the outset the project team needs to collect data about present performance, so that it can assess the current state of the service provided, and begin to track changes as Telecare is introduced. This baseline data together with ongoing data collection helps to show if the change is making a difference.

Major stakeholders value different outcomes, so the project team needs to seek measures of performance that will meet the needs of service users, carers, and staff, as well as demonstrate the contribution of telecare to operational and strategic measures. Consider the language used in describing the outcomes and measures to ensure that a broad range of stakeholders’ needs can be addressed.

The ideal data is unlikely to be readily available, so you need to use some ingenuity to see what you can secure that will be good enough for your purposes, and at the same time try to identify ways of improving the data that you receive.

Important steps include:

• Identifying what you need to measure;
• Identifying available and adaptable measures / data i.e. that which is already being collected (be aware of different performance measures and reporting used by different stakeholder organisations that may be useful);
• Using those to establish baselines at the start of the project;
• Plan to gather comparable data at future periods to measure progress, preferably from existing or easily adapted sources, e.g. call handling data, admissions to hospitals and care homes, number of delayed discharges, etc.

Identifying key measures of performance

These derive from the outcomes established for the project (refer back to Section 3.3) – what are the key measures that will show that the project is achieving its proposed outcomes? Including several dimensions of performance may also encourage creative thinking.

Some examples include:

Financial or business measures:

• Number of care home nights purchased and the pattern of purchase (e.g. who is assessing the level of need, who is accessing the service, average length of stay, etc?)
• Number of delayed discharges (available from statutory performance returns collated by the partnership)
• Number of unplanned hospital admissions

Service measures

• Satisfaction surveys. – e.g. benefits of independent living
• Interviews
• Anecdotal examples of success stories
• Satisfaction survey at outset of project to establish a baseline
• Other measures of quality of life

Process/efficiency measures

• Speed of dealing with referrals, installations, response, etc
• Local efficiency savings (current costs / expenditure on services, etc)

Resources in place

• Numbers of telecare packages installed
• Current pattern of support service provision, e.g. sleepovers, waking night staff, home care hours, etc

Identify available data

It is better to start with existing data sources – though inevitably these will be broad, and it will be difficult to attribute changes exclusively as the result of the Telecare project. But they can be tracked and perhaps eventually adapted to show the contribution of Telecare to strategic objectives. Possible data sources include:

• SPARRA (Scottish Patients At Risk of Readmission and Admission – Information Services Division, NHS Scotland)
• Community alarms, home care and care home service usage profiles
• Patterns of existing service provision by locality / service user group – available from both NHS Boards and local authority
• Patterns of unpaid care and uptake of respite provision
• Single Outcome Agreement performance measure framework and reports
• Quarterly monitoring returns from the National Telecare Programme
• Current expenditure patterns from internal financial reports
• Census information
• Local authority and NHS Board planning information
• National sources, including Information Services Division (ISD), etc

As possible sources are identified, the project team should then ask:

• Who owns, or is responsible for, these data sources?
• Are they willing to provide or adapt the data needed?

Establish baselines

List key measures and current performance as a baseline e.g. average length of stay in a care home = 24 months, etc. The project team needs to decide how many measures to use: it is usually best to focus on a small number of critical measures that represent the major outcomes, but these need to be sufficient for a case for telecare to be argued. Balance the number of measures against the time and resources needed to collect and track them.

Gather and communicate comparable data to measure progress

Questions to consider within the project team include:

• How will we gather information?
• How frequently?
• How to present and distribute it?
• Who are our key audiences?
• What do we need to include in regular reports?

Be imaginative – good quality visual presentations will have a bigger impact than dull ones. Remember the purpose – to build support and commitment towards the project, as well as to learn how it is performing. Presentations and reports should be specific or adapted for different audiences.

Include actions within the project plan to establish performance measures and baselines for the telecare project where these do not currently exist but are necessary. See Tool 9 for the Outcomes and performance measures example template.