The Care Aims Intended Outcomes Framework is a powerful approach to service improvement. It is based on a population and person-centred philosophy which focuses on fundamental ethical principles.
The approach provides a strong strategy that encompasses engaging and informing the population and empowering the workforce to enable service users and their families to maintain and improve their well-being.
Service provision is spread across all four levels of risk management (fig 1), requiring a robust skill mix to manage complex cases and undertake sophisticated decision making and negotiation.
The framework supports clear reasoning and evidence-based decision-making focused on fundamental human needs and person-centred well-being outcomes. It facilitates the strengthening of collaborative care planning with the service user’s story and life plan at the centre. It has been shown to reduce variability of outcome by promoting transparency, continual evaluation and a common language for communicating professional reasoning. It ensures that reflection on intended outcome (not outcome per se!) is at the core of all governance methodologies designed to improve the effectiveness of services.
Over 15 years of experience of collaborating with services to use this framework has helped us distill the key factors required to support the significant culture transformation it often achieves. Outcome become the focus of all conversations at every level of the system and collaboration around personal outcome becomes an essential mode rather than “nice to have”.
Key benefits have been found to be:
- Better user experience and access with greater autonomy
- Continual quality improvement through reflective practice
- Clear evidence of effectiveness and professional reasoning
- Resources targeted where they can make the most difference
- More collaborative decision-making and data to support information sharing, analysis of effectiveness and value for money.