Implementing Telecare
Set specific objectives and measures of success

Being unclear about outcomes is probably the main reason for project failures – while clear outcomes can be motivating (for those who agree with them) and help people to work efficiently. Having established the broad vision and outcomes (as described in Section 2.5) within the terms of reference document, the project team then needs to go through a similar process to establish specific objectives for each of the outcomes from successive stages of the work, and/or for major sub-projects. This section cross-references with Section 4.3 which considers outcomes measures in more depth.

Outcomes are NOT the same as inputs, activities or outputs.

• Inputs: are essentially resources that get used up in the provision of a given service, e.g. money/staff.
• Activities: are what an organisation does with inputs to achieve its purpose, e.g. carry out assessments, install telecare equipment, handle calls, and respond to emergencies.
• Outputs: are direct products of activities, e.g. the number of people with a telecare package, the number of people maintained at home. Outputs are important because we assume they lead to something else such as an improvement in quality of life (e.g. feeling safer). This is an outcome.
• Outcomes: are more generally understood as what service users are enabled to do, or what has changed in their condition, as a result of a service being provided.

To assess progress on outcomes, appropriate measures or indicators of success should be identified. Because outcomes can be subjective and direct contact with the people affected is not always possible, it is common to infer outcomes on the basis of suitable measures of output. This is the approach that has been adopted for the National Community Care Outcomes Framework.

Thinking about outcomes and their links to outputs is valuable because it:

• Forces you to think clearly about what you are actually trying to do, and how this could be measured.
• Allows you to assess whether you are actually making a difference to people’s lives.
• Provides a measurement against which an organisation can review its approach and adapt it to become more effective over time.
• Provides evidence of the impact of funding from a range of sources (e.g. government, other funders and the public) on direct benefits for people.

A robust performance management system has benefits on a number of levels and, when used effectively, can help organisations to focus clearly on what they need to deliver. It is no accident that the most successful and innovative organisations are usually underpinned by good information systems that allow them to self manage effectively. Being able to demonstrate input/activities/outputs/outcomes effectively can also be extremely useful to the project manager in discussions about resource requirements.

From broad outcomes to early implementation objectives

People will support an activity if they know and value what it will achieve. This includes external stakeholders who need to see value in a project, and those directly involved in the project (internal stakeholders). Being clear about intended outcomes also helps the project team to work efficiently – if they know the purpose of a task they can adapt intuitively to new circumstances, without waiting to be told what to do.

From objectives to measures of progress

Objectives then require specific measures to be identified which will indicate whether or not the overall outcome has been achieved. These measures can be quantitative and/or qualitative. A success measure will only be useful if the data required to deliver it is readily available and accessible – preferably using existing sources of data. A measure which depends on someone collecting new data means new processes for data collection need to be developed and put into practice – i.e. more work!.

Telecare projects will achieve several types of outcome – with different measures of success. For example:

Developing clear outcomes, objectives and success measures at all levels of the project helps to:

• Ensure the project is focused on delivering outcomes that meet the interests of stakeholders
• Convince stakeholders that it is meeting their interests, and so retains their support
• Design and conduct an efficient process for monitoring and evaluation