Measuring the Impact of Service Delivery Through Outcomes - FocusedPlanning and Partnership Working

Parvinder Chana 2009

What is the purpose and direction of OBA?

– starts with the ends– works backwards, – common language – work effectively with partners – budgetary requirements are defined and

appropriate– low/non cost initiatives implemented almost

immediately – talk to action quickly – best outcomes

Benefits of OBA

– Integrate local data– link to outcomes to support service planning– Identify data gaps– prioritise outcomes and performance indicators– joint ownership for the agreement of desired

outcomes – actions necessary to achieve them,– either within a community or within a service area

Outcome Based Accountabilityis made up of two parts:

Population Accountabilityabout the well-being of

WHOLE POPULATIONSFor Communities – Cities – Counties – States – Nations

Performance Accountabilityabout the well-being of

CUSTOMER POPULATIONSFor Programmes – Agencies – and Service Systems

OBA Example

Outcome • Lose weight and be more confident Indicators • Number of lbs lost• Decrease in dress size• Increase in confidenceStory behind the baseline (causes)• No time to exercise• Eating out most of the time because there’s no shopping in the

house• Eating in a rush and not thinking about how healthy the food I’m

eating is• Sitting at a desk all day at work

OBA Example Continued

Partners • Partner • Dog• Gym instructor • Work colleague • Friends

What works? • Weightwatchers • Calorie controlled diet• Physical activity

OBA Example ContinuedAction Plan • Join local gym• Initial gym lesson with gym

instructor to produce a workout plan for me to follow

• Go gym every Monday (and one other day during the week)

• Go shopping with my partner every Sunday

• Join Weight watchers and plan a healthy

• shopping list for the Sunday shopping

• Reward with an outfit at the end of each month

• Take a packed lunch from home to eat at work

• Walk up the stairs at work and not use lift

• Use the toilets on the 1st floor and use stairs to toilets and office each time

• Take dog out for 30 minute walk every other day

• Go for a walk at lunch time with work colleague

• Join Salsa class with friends

Population Accountability

Using OBA

Working through 6 Exercises 1. Common ground (will help to look at identifying

partners for the action planning stage)2. Choosing priorities 3. Outcomes & Indicators 4. Story behind the baseline (Analysis of plotted

chart)5. What Works? (locally, regionally, nationally)6. Action planning/partners

Performance Accountability

Three Simple Performance Measure Categories

• How much did we do?

• How well did we do it?

• Is anyone better off?

All performance measures…

…that have ever existed for any

service can be derived from

thinking about the quantity and

quality of effort and effect

Quantity and Quality

Distinction between quantity and quality is familiar:

How much we did Vs

How well we did it

Some people think that quantity can bemeasured but quality cannot bemeasured – but it can based on 12 words 1. Did we treat you well?2. Did we help you with your problems?

Effort and Effect

The distinction between Effort and Effect

is simply the difference between how hard

we tried and whether we made a

difference in the lives of our customers

Quantity Quality

How MuchDid we do?

How WellDid we do it?

EffortHow hard did we try?

EffectWhat change did we produce?

Different perspectives combined

• Quantity of effort: How much service was provided?

• Quality of effort: How well was the service provided?

• Quantity of effect: How many customers are better off?

• Quality of effect: What % of customers are better off and how are they better off?

How much did we do? Least important

How well did we do it? 2nd Most important

# is anyone better off 3rd Most important

% is anyone better off Most important

How much do we do?# Customers served (by customer characteristic)

# Activities (By type of activity)

How Well did we do it?% Common measures Workload ratio, Staff Turnover rate, Staff

morale ,Percent of staff fully trained, Worker Safety, Unit cost , Customer satisfaction (did we treat you well?)

% Activity-specific measures Percent of actions timely and correct, percent clientscompleting activity, percent of actions meeting standards

Is anyone better off?# Skills/Knowledge # Attitude/Opinion # Behaviour # Circumstance

Is anyone better off?% Skills/Knowledge % Attitude/Opinion (including customer satisfaction)% Behaviour % Circumstance

Group Exercise

1. Pick a service in your group 2. Think about the common measures for the

service and plot them into the quadrant3. Discuss and identify any gaps in measures

and plot them into the quadrant4. Pick measures from the right hand upper

and lower quadrants and identify barriers 5. Refer back to your barriers and discuss

actions that could help over come these barriers

How does this link to Population Accountability

A population workshop organised where partners cometogether will help to identify areas that potentially couldbe included/improved in your service development - Use this as a basis for your background to plan yourperformance workshop• Think about the measures that were identified in the population

workshop• think about what links your service into the population measures• what are the gaps in your measures • At the population review share best practice from your agency

that is evidence based as what works for your service

Measuring Outcomes

• When thinking ‘is anyone better off’ think about how you identify the outcome for individuals and how you will know if they have moved to achieving the outcome. (Distance Travelled)

• Build this into your initial assessments reviews and closure so you can see whether the service is moving the individual in the right direction

• Link your presenting factors (why intervention was needed) to your Trust priorities and the ECM Framework

Partnership Working

• You cannot solve population wide issues as a single service

• Look outside your own world view and see how you can work with other agencies/services to improve outcomes together