Muir Gray: Setting objectives for systems of care

Muir GrayRead the rest of this series of blogs about designing and planning population based systems of care here.

Step 3: Setting objectives

Having defined the scope of the system and agreed the population to be served, the next step is to set objectives.

Objectives are needed in every area where performance and results directly and vitally affect the survival and prosperity of the business. Objectives should enable us to do five things:

  1. To organise and explain the whole range of business phenomena in a small number of general statements.
  2. To test these statements in actual experience.
  3. To predict behaviour.
  4. To appraise the soundness of decisions when they are still being made.
  5. To enable practising business men to analyse their own experience and, as a result, improve their performance.

Source:  Drucker P. The Practice of Management. Elsevier, Butterworth-Heinemann, 1955 p.54-55.

It is good to set a single aim, for example, “to help people with liver disease lead fulfilling lives.”

However it is also important to complement and supplement the aim with a set of objectives, but when setting objectives it is important to distinguish between two types of objective. The first type of objectives are structural, for example, “to provide a consultant led service.” Important though such objectives are they tend not to be objectives which are related to setting up a service. They are “all or none” objectives, either present or not, and it is more important to focus on the type of objectives that are set for a service and which would be expected to vary year on year.

Not more than ten objectives should be set and these can be fitted into the matrix below. Set out below is a draft set of objectives as a basis for discussion.

Objectives Criteria Standard
To diagnose and treat liver disease quickly and accurately.
To treat liver disease effectively and safely.
To engage people with the condition and their carers as equal partners.
To promote the health of people with liver disease.
To develop the professionals who support people with liver disease.
To make best use of resources.
To promote and support research.
To produce an annual report for the population served.

Muir Gray
is visiting professor of knowledge management, Nuffield Department of Surgery, University of Oxford.