Measuring the impact of service delivery through outcomes

Measuring the Impact of Service
Delivery Through Outcomes Focused
Planning and Partnership Working
Parvinder Chana
What is the purpose and direction of
starts with the ends
works backwards,
common language
work effectively with partners
budgetary requirements are defined and
– low/non cost initiatives implemented almost
– 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
– actions necessary to achieve them,
– either within a community or within a service area
Outcome Based Accountability
is made up of two parts:
Population Accountability
about the well-being of
For Communities – Cities – Counties – States – Nations
Performance Accountability
about the well-being of
For Programmes – Agencies – and Service Systems
OBA Example
• Lose weight and be more confident
• Number of lbs lost
• Decrease in dress size
• Increase in confidence
Story behind the baseline (causes)
• No time to exercise
• Eating out most of the time because there’s no shopping in the
• 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
Gym instructor
Work colleague
What works?
• Weightwatchers
• Calorie controlled diet
• Physical activity
OBA Example Continued
Action 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
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
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
How well we did it
Some people think that quantity can be
measured but quality cannot be
measured – 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
How Much
How Well
Did we do?
Did we do it?
How hard did we try?
What change did we produce?
Different perspectives
• Quantity of effort: How much service was
• Quality of effort: How well was the service
• 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
How Well did we do it?
% Common measures
(by customer characteristic)
Workload ratio, Staff Turnover rate, Staff morale ,Percent
of staff fully trained, Worker Safety, Unit cost ,
Customer satisfaction (did we treat you well?)
# Activities
(By type of activity)
% Activity-specific measures
Percent of actions timely and correct, percent clients
completing activity, percent of actions meeting standards
Is anyone better off?
Is anyone better off?
# Skills/Knowledge
# Attitude/Opinion
# Behaviour
# Circumstance
% 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 quadrant
3. Discuss and identify any gaps in measures
and plot them into the quadrant
4. 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
How does this link to
Population Accountability
A population workshop organised where partners come
together will help to identify areas that potentially could
be included/improved in your service development
- Use this as a basis for your background to plan your
performance workshop
• Think about the measures that were identified in the population
• 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
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
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