Suzie Forell has been leading Health Justice Australia’s work to develop an outcomes framework for evaluating health justice partnerships.
As a national centre of excellence, Health Justice Australia seeks to build an evidence base around the value and impact of health justice partnerships (HJPs). A first step in this process is to support a shared understanding between service partners and across the network of HJPs about the differences that health and legal services seek to make by coming together in partnership.
At the same time, many HJPs are seeking guidance, support and resources from Health Justice Australia about how to identify outcomes and how to measure them. To address both these needs, Health Justice Australia is developing a shared outcomes framework for health justice partnership.
To do this, we are working with the network of HJPs and other stakeholders (including funders, researchers and communities) to establish a shared vision, identify expected outcomes, to prioritise indictors and measures, and to develop common tools to collect, report and communicate findings. We have sought to use existing validated tools but have identified the need to also develop and test new tools for this type of cross-disciplinary work.
Context and particular challenges for this work
There are 73+ services on the Australian health justice landscape. As described in our recent census of this landscape, all services provide legal help in a healthcare setting, most commonly for clients experiencing socio-economic or other disadvantage and likely to have unmet health-harming legal/social issues. However, as interventions, they are not homogenous. These vary in setting type (hospital, general community health, mental health, infant health, Aboriginal health), partner types, client types, how services come together, the help they provide and the scope of shared work (e.g. client services only, cross-disciplinary training etc). In evaluation it is important to understand exactly what the intervention or service is. As these health justice services differ from each other, we need to identify shared and differing features of services, as well as their impact.
The rationale for services to come together in partnership also varies. Very broadly, legal services aim to reach and assist clients who are known to have unmet legal need but do not seek legal help. Health services value the capacity to offer legal/welfare assistance for problems which are affecting their patients’ health, but are otherwise beyond the services’ remit, capability or resources to provide. Framed as a shared rationale – services partner across silos because alone, they cannot effectively address the complex and intersecting issues affecting certain clients. From a patient or client perspective, HJPs may provide more accessible, holistic, coordinated, timely care that better addresses their intersecting needs.
Outcomes can look different depending upon your vantage point.
The challenge for an outcomes framework is:
- to take account of what different stakeholders want/want to know about this type interdisciplinary work, and what outcomes matter and to whom
- to recognise the different beneficiaries of health justice work – clients and communities, but also partner services, their staff, funders and governments
- to identify shared interest and impact.
Through the work we have done with HJP services and our research partners, we have developed a draft theory of change for HJP. As we test this with the network we are also developing a bank of relevant indicators and data collection tools that health justice partnerships can use in their evaluation work, that link directly to the shared outcomes framework. Beyond that we are looking at a portal through which services can record data against those indicators.
The strength of this project will be in the work we do together. If you would like to know more about this work, or would like to be involved, contact us at healthjustice@healthjustice.org.au
