Measuring the social impacts of a QI project
Measuring the social impacts of a QI project
Centre for Sustainable Healthcare, February 2017
Introduction
There is no single method for measuring social impacts in healthcare. Health services can influence the social circumstances of patients, carers, dependents, staff, local and distant communities (e.g. people working in the supply chain). Types of impact can be diverse and may include:
- Housing status
- Poverty
- Health and wellbeing
- Education
- Employment status
- Safety & security, freedom from violence
- Satisfaction / happiness & quality of life
- Participation in society / social inclusion
- Social gradient / inequalities
Clearly, it is not practical to measure every type of impact in every group for each service. So the aim is to identify those people likely to be most affected, the nature of any impacts and their importance to the people concerned. Then work out how you could measure them – easy!
Planning your social impactevaluation
Step 1. Identify groups whose social circumstances may be affected by your service or service change
Thinking carefully about your service or project, make a note of possible social impacts on different people in the relevant boxes in Table 1. It may be worth reading up to find out about impacts on distant communities – e.g. have a look at work by the BMA Medical Fair & Ethical Trade Group.Highlight the boxes/impacts that seem as if they may be most significant.
Step 2. Where possible, find out which impacts are most important to the groups concerned.
Youmay suspect for example that carers taking time off work to bring their relatives to hospital will be an important impact. If possible, check this assumption with them – perhaps using a quick survey or focus group. Their concerns may be altogether different!
Step 3. Identify outcome measures
Having decided on the one or two most important social impacts for your project, now consider how you could measure these (Table 2). Surveys of patients, carers and staff can be useful, but remember that these may need ethical approval,can be time consuming to conduct and need to be carefully designed if they are to provide valid results. Could you get the most important information in another way, e.g. by looking at data (such as postcode or arrival time) that is already recorded? If you do decide to use a survey, wherever possible use a questionnaire that has already been properly validated.
If you would like to capture wider impacts (e.g. on inequalities in accessing care) and are not sure where to start, getting advice from a public health colleague can be very useful.
1
Sustainability in Quality Improvement training materials developed with grant funding from North Bristol NHS Trust.
The Centre for Sustainable Healthcare is registered in England & Wales as a company limited by guarantee No. 7450026 and as a charity No. 1143189. Registered address: 8 King Edward Street, Oxford, OX1 4HL.
Measuring the social impacts of a QI project
Table1: Scanning for social impacts
Social impact area ⬇ / Patients / Carers / Dependants / Local community / Distant communities / StaffHousing
Poverty
Health
Education
Employment
Safety & security
Satisfaction
Participation
Social gradient
Table 2: Social impacts – identifying outcome measures
Social impact area / Group affected / Outcome measure1
Sustainability in Quality Improvement training materials developed with grant funding from North Bristol NHS Trust.
The Centre for Sustainable Healthcare is registered in England & Wales as a company limited by guarantee No. 7450026 and as a charity No. 1143189. Registered address: 8 King Edward Street, Oxford, OX1 4HL.