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M&E REINVENTED Validate Results, Inform Practice, Improve Outcomes in Real Time Global Youth Economic Opportunities Summit October 7, 2014

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Page 1: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

M&E REINVENTED Validate Results, Inform Practice,

Improve Outcomes in Real Time

Global Youth Economic Opportunities Summit October 7, 2014

Page 2: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series
Page 3: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Roles in society

Contributions to individual and

community well-being

Impact on civic engagement

Economic impacts

Relationships with government

and business

Page 4: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

IMPACT – How do you define it?

IMPACT BROADLY

How many people or organizations were served through your programs?

In what ways were they helped?

oGain knowledge

oLearn new skills

oEmpowered

oChanged behaviors

IMPACT NARROWLY In what ways did your

Program or Initiative

Make your … Community or Issue Area Better?

Did your contribution CAUSE the results you see?

Page 5: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Evaluation and

Learning…A Continuum

Page 6: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

What can we learn? Can we do better now?

Did we succeed?

What difference did we make?

Page 7: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Did we succeed?

Impact evaluations • Random control trial

• Quasi-experimental designs using statistical techniques

Important, but expensive and long-term • Results take time – usually many years

Page 8: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Can we do better now?

Performance Management

Continuous Quality Improvement

Rapid Cycle Evaluation

YES

Page 9: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Your organization is striving to be high

performing. That means:

Your leadership guides the efforts

You strive to have sufficient analytic

capacity (staff capabilities and data

system capabilities)

You have created a culture supportive

of innovation where staff can safely

share successes and failures

You have a continuous cycle of learning

Page 10: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Combining good management

with evaluation techniques

= Rapid Cycle Evaluation

Page 11: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Rapid Cycle Evaluation

Identify element of operational process

Decide on how to vary the process

Randomly select part of your population

Implement

Evaluate

Adopt or Reject

Page 12: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Learn More About What Works here:

www.PerformWell.org

a partnership between Urban Institute Child Trends and Social Solutions

Page 13: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Impact is Important but

Continuous Learning is Essential

Continuous learning will help you examine impact:

You routinely collect and examine your data

Helps you identify “why” questions

Provides context for how well you program works in many situations

Page 14: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Social Solutions provides web-based

tools that measure the strength

and impact of transformational

relationships.

Confidential - Copyright, 2014 Social Solutions Global All

Rights Reserved

Page 15: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Modeling the Social Determinants of Health Outcomes

Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost.

IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2012. (Available on www.IHI.org)

After Evans and

Stoddart

Well

Being

Case

Management

Care

Management

Page 16: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

SHIFT TO HIGH PERFORMING WHERE DO I START?

Page 17: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Evolution of Directional Intelligence

Page 18: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Tools should project our path from need to strength AND reveal trajectory while guiding practitioners along the way and helping us take corrective action when we

lose our way.

Page 19: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

IF WE BELIEVE OUR WORK MAKES A

MEASURABLE DIFFERENCE…

HOW CAN WE MOVE FROM INTUITION TO CORRELATION?

Confidential - Copyright, 2014 Social Solutions Global All Rights Reserved

Target

Population

E

E

E

E

E E

Trajectory

Baseline

Effort = Cost = Investment Frequency

Duration

Type

Impac

t =

Benefit

= R

etu

rn

Period of Service

Page 20: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

SCIENCE OF SERVICE DELIVERY

REVEALS TRAJECTORY & LIKELIHOOD

Confidential - Copyright, 2014 Social Solutions Global All Rights Reserved

Target

Population

Posi

tive

Im

pac

t

Period of Service

E E E

E

E

E

E

Page 21: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Roca has taken the stages of change and adapted

them for a very high-risk youth development

model. Roca uses the stages of change as:

Stages of Change & Roca

1) an assessment where young people are in relation to their readiness

and/or willingness to change;

2) a guide to inform youth workers’ use of self in their work with young

people; and

3) a foundation for designing engagement and competency-building

programming that meets young people where they are.

In 2013, Roca was awarded a six-year $23 million

Pay for Success Contract by the Commonwealth of

Massachusetts.

Page 22: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Contemplation Precontemplation Action Preparation Maintenance

Stages of Change (TTM) – What Does the Science tell us?

Key concepts in Stages of Change approach:

• Behavior change is a process that unfolds though a series of stages

• Individually tailored messages have positive effects on those who are ready,

getting ready, or not ready to change behavior

• Can have an impact on all participants – and predict future change

Behavior has

changed

What behavior change interactions are most effective for those who need to change

behavior?

Page 23: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Integration of Stages and Processes of Change

Precontemplation Contemplation Preparation Action Maintenance

Self-Reevaluation

Self-Liberation

Helping Relationships

Counter-Conditioning

Reinforcement Management

Stimulus Control

Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change:

Applications to addictive behaviors. American Psychologist, 47(9), 1102-1114.

Social Liberation

Dramatic Relief

Consciousness Raising

Environmental Reevaluation

Stages and Processes of Change Correlate with ETO

Page 24: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

WHAT KEEPS US FROM IMPROVING? Maybe we are TOO BUSY…

Page 25: Urban Institute Identity Implementation · Stiefel M, Nolan K. A Guide to Measuring the Triple Aim: Population Health, Experience of Care, and Per Capita Cost. IHI Innovation Series

Please send questions to:

Teresa Derrick-Mills

Senior Research Associate

The Center on Nonprofits

and Philanthropy

Urban Institute

[email protected]

Adrian Bordone

Founder

Social Solutions

[email protected]

Bojan Cubela

Director, Workforce

Development

Social Solutions

[email protected]