Measuring Consumer Enablement
Measuring enablement can help you provide better care, by supporting decision making and helping you identify, assess, monitor and measure interventions.
To improve consumer enablement, you need to be responsive to people in diverse situations with varying levels of enablement, and understand the factors that influence enablement. This involves the following skills:
- the ability to assess and describe complexity and enablement levels of individuals and specific target groups
- the ability to effectively respond to people’s identified enablement status
- the ability to monitor changes in enablement and adapt strategies and approaches accordingly.
In addition to providing you with the above skills, measuring enablement can help you develop:
- needs assessments to support decision making
- quality assessments and monitoring
- outcomes measurement.
How to measure enablement
There are many ways to measure aspects of enablement, but there is no one tool that measures all four components of enablement (cognitive, motivational, physical and relational) or overall enablement. Formal measurement may not always be necessary. Sometimes, your professional judgement is the most useful tool at your disposal. Assessment tools should support but not replace your judgement. In fact, they may be unsuitable for people with very low levels of enablement. A structured conversation that considers the different components and determinant of enablement may be more suitable. The key is to establish the determinants, components and overall level of enablement, apply appropriate strategies, then evaluate the outcomes. You may need more than one assessment tool to do this. When using an assessment tool, you should consider whether it has been fully tested and validated.
There is more information about the different tools available for measuring aspects of enablement in the Analysis of tools that measure enablement, an excerpt from the Evidence check on consumer enablement.
Types of assessment
At the individual level, there are three ways that formal assessments can be used.
- The assessment is scored and the overall score guides decisions about the type of services delivered.
- The assessment is used as a checklist to consider different aspects of enablement when developing a care plan, with decision making based on answers to individual questions, rather than an overall score.
- The assessment is used as part of the shared decision-making process between the healthcare provider and consumer.
Alternatively, you can combine the first and second options above. In this model, an assessment tool with multiple scales covering different aspects of enablement (such as the Health Literacy Questionnaire) is used to create a profile of strengths and weaknesses. This profile, rather than a single score, can inform your thinking and decision making. This model can also support shared decision making, if the profile is used as the basis for discussions with the consumer.
- Batterham R, Osborne R, McPhee C et al. Consumer enablement: an Evidence Check rapid review brokered by the Sax Institute for the Agency for Clinical Innovation. Ultimo, NSW: Sax Institute; 2017.
- Independent evaluation of the feasibility of using the Patient Activation Measure in the NHS EnglandOrganisationThe Health FoundationDescriptionInformation that may be useful for organisations considering using the PAM or other appraoches to support consumers to recognise and develop their strengths and abilities to manage their health.URLLicensing/Cost--
- Patient Activation in the NHSOrganisationNHS EnglandDescriptionHow the PAM is used in the NHS to assess patient activation and support consumer self-management.Licensing/Cost--
- Patient Activation Measure (PAM)OrganisationInsignia HealthDescriptionThe PAM identifies where an individual falls within four different levels of activation which can give providers insight to more effectively support each individual.Licensing/CostLicence required and fee applies.
- Supporting people to manage their health: An introduction to patient activationOrganisationThe King's FundDescriptionArticle about the PAM written by the creators of the PAMLicensing/Cost--