Outputs and outcomes in healthcare

Outputs and outcomes in healthcare

Outputs are the 'products' of actions and processes. Yet, some outputs can also be a 'consequence' of previous outputs. We can differentiate between them by referring to the former as 'outputs' and to the latter as 'outcomes'.

The main difference between outputs and outcomes, then, is that an output, produced by actions or processes, can be managed directly (eg, behaviours produce those outputs: correct behaviours lead to appropriate outputs, errors lead to inappropriate outputs). An outcome, on the other hand, can only be managed indirectly, by way of producing the antecedent outputs (eg, a drug administered correctly will probably lead to recovered health, an error in administering the drug may lead to harm or death).

This differentiation may seem a bit too theoretical but it has its practical implications. One such practical implication is that in order to achieve the expected outcomes the appropriate outputs need to be produced first. Yet, sometimes is not possible to fully predict interactions between outputs and, thus, their consequences. In environments such as healthcare, where many unforeseen variables may affect behaviors and outputs, outcomes may not be achieved as expected. There is always uncertainty about the correlation between outputs and outcomes, and healthcare professionals need to be on the lookout for things not proceeding as expected and, therefore, failing to achieve the expected outcomes.

A good example of unforeseen variables and potential complex interactions in healthcare is an allergic reaction leading to anaphylaxis upon injecting a drug. If we didn't know about the potential allergy, then the anaphylactic shock comes as a surprise, such surprise being greater if we actually believed that the patient was not allergic.

Examples of outputs and outcomes in healthcare environments
Behaviour Outputs / products Outcomes / consequences
Drug administration Drug administered recovered health, death…
Observation & diagnosis Diagnosis & prescription recovered health, waste of time / money, allergic reaction…
Food preparation Meals nourishment, food poisoning…
X-ray processing X-ray image
Operation Removed tissue cancer-free patient, complications…

Another practical implication is that outputs and outcomes may not be the same for different departments and specialties. Even more, the relevant 'definition' of safety / healthcare for different specialties may be different, as well. Some specialties (and activities withing specialties) focus more on controllable outputs while others focus more on correlative outcomes.

For example, a surgeon's main focus is the organ or tissue to be repaired or removed. Surgeons should be quite capable of operating without even needing to know a patient's name or look at his face. Even more, knowing a patient's name or face does not sensibly add to the operation's success1. The organ or tissue is the object.

On the other hand, an anaesthetist may be highly proficient in operating equipment and injecting drugs but her focus is on outcomes such as a well induced amnesia and analgesia, which varies between patients and along time. Analgesia and amnesia are the object, and this requires more than simply turning a knob or a good syringe.

Examples of outputs and outcomes for different specialties / activities
Specialty Main focus
Nurses outcomes (eg, recovered health)
Surgeons outputs (eg, effective operation)
Anesthetists outcomes (eg, well induced amnesia, analgesia and paralysis)
Lab technicians outputs (eg, good quality X-ray image)
Dietitians outcomes (eg, appropriate nutrition)
Physicians outputs (eg, good diagnosis and prescription )
Pharmacists outputs (eg, good drug preparation and information)
Administration outputs (eg, good filing, timetabling and accountability)

In summary, even in the word 'healthcare' we can observe both an output and an outcome. 'Care' is, for the most part, an output, something we can achieve professionally by "doing the right thing". 'Health', on the other hand, is an outcome, something we can expect to achieve with 'care' but not always fully predict. We may need 'extra care' if we want to provide better health and safety to our patients, and this 'extra care' is, for the most, not just "more of the same care", but a qualitatively different one. Here is where human factors comes in.

Want to know more?

Outputs & outcomes: HF issues Other outputs & outcomes MRSA as outcome

Author

Jose D PEREZGONZALEZ (2011). Massey University, New Zealand (JDPerezgonzalezJDPerezgonzalez).


Other interesting sites
320
Journal KAI
105px-Stylised_Lithium_Atom.png
Wiki of Science
120px-Aileron_roll.gif
AviationKnowledge
Artwork-194-web.jpg
A4art
Artwork-162-web.jpg
The Balanced Nutrition Index
Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License