ways to measure the efficiency of care/service delivery

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Solution:
Efficiency measurement: Measuring efficiency gains from increased productivity is essentially about calculating how much staff time is saved by doing things differently. This may happen in one of three ways:
• improved outputs or outcomes for the same staff time
• the same or improved outputs or outcomes for less staff time
• considerably better outputs or outcomes for slightly more staff time

These need to be converted into a cash value if they are non-cashable, that is, if they do not do not release money through a lower pay bill etc. Figures must be robust since the annual efficiency statements (AES) will be audited as part of the Comprehensive Performance Assessment (CPA) 'use of resources' assessment.
The Office of Government Commerce (OGC) produced guidance on measuring productive time efficiency gains in April 2005. It identified three approaches to measurements:
• measurement by task
• measurement by role
• measurement by service delivery

The best approach will depend much on the service or job type in question. Used inappropriately, measurement systems may use more time than is saved through increased productivity. A baseline measure is required to show efficiency gains, so measurement must begin before the initiative. The services is delivered is changed. Increasing their productive time involves maximizing time spent on 'core' tasks - those which add the most value for the skill level of the individual involved. It is essentially input and process based.

Measurement will therefore involve coding tasks in some way; measuring time spent on core and non-core tasks; and converting the reduced amount of time spent on non-core tasks into a cash figure by using salary or total staffing costs. Various techniques can be used to do this.

Time-recording systems are particularly useful when staff time is being charged to different cost centers. However it risks being an unnecessary burden if used in the wrong context. Indeed, some local authorities have reported abandoning time-recording systems as productive time efficiency gains! A sample of employees may be an alternative.

Work study is resource-intensive but may be an integral part of large scale business transformation or whole systems approach to service improvement to establish where staffing costs are greatest and what the impact of the change was.

Activity based costing (ABC), a common approach in criminal justice, is based on coding tasks, for example by whether they are frontline or support work However it will be onerous if not used already for financial reporting. Also, it may not always be appropriate in local government to separate frontline and support ...