Outcome Based Accountability

Transcription

1 Outcome Based Accountability Getting from Talk to Action This presentation is based on the intellectual property of the Fiscal Policy Studies Institute (FPSI), Sante Fe, New Mexico, USA and is made available by permission of the owners for use free of charge by government and non-profit/voluntary sector organisations. For information about licensing arrangements for other uses, please consult Outcome Based Accountability and OBA are trade marks of the FPSI. Fiscal Policy Studies Institute Santé Fe, New Mexico (publications) 1

2 Outcome Based Accountability Simple Common Sense Plain Language Minimum Paper Useful Outcome Accountability Common Language Common Sense Common Ground 2

3 Outcome Accountability is made up of two parts: Population Accountability about the well-being of WHOLE POPULATIONS for neighbourhoods districts regions - countries Performance Accountability About the well-being of CLIENT POPULATIONS for projects agencies service providers The Language Trap Too many terms, Too few definitions, Too little discipline Qualitative Performance Measures! Outcome Benchmark Measurable Systemic Objectives! Result Indicator Priority Strategic Outcomes! Modifiers Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic Goal Targeted Incremental Results! Measure Target Objective 3

4 Definitions Outcomes Indicators Performance Measures OUTCOMES Definitions A condition of well-being for children, adults, families or communities. Children born healthy Children succeeding in school Safe communities Clean environment Prosperous economy Positive, jargon-free statements of well-being in plain language that people can understand A condition of well-being for people in a place... 4

5 Outcomes for Communities: Healthy Births Healthy Children and Adults Children Ready for School Children Succeeding in School Young People Staying Out of Trouble Stable Families Families with Adequate Income Safe and Supportive Communities Every Child Matters Outcomes Being Healthy: enjoying good physical and mental health and living a healthy lifestyle. Staying Safe: being protected from harm and neglect and growing up able to look after themselves. Enjoying and Achieving: getting the most out of life and developing broad skills for adulthood. Making a Positive Contribution: to the community and to society and not engaging in anti-social or offending behaviour. Economic Well-being: overcoming socio-economic disadvantages to achieve their full potential in life. 5

6 Adult Social Care Outcomes Improved health and emotional well-being Improved quality of life Making a positive contribution Exercise of choice and control Freedom from discrimination and harassment Economic well-being Personal dignity From our health, our care, our say: a new direction for community services, NHS, January 2006 Definitions INDICATORS A measure which helps quantify the achievement of an outcome. Rate of low birth weight babies (Children Born Healthy) Key stage test scores (Children Enjoying & Achieving) Violent Crime Rates (Safe Community) Air Quality Index (Clean Environment) VAT Registrations (Prosperous Economy) How would we recognise these outcomes in measurable terms if we tripped over them? 6

7 Performance Accountability Population Accountability Definitions PERFORMANCE MEASURES A measure to evaluate how well a programme, agency or service system is working. Three questions: How much did we do? (quantity) How well did we do it? (quality) Is anyone better off as a result? (quantity and quality of effect or customer/client outcomes) Performance measures tell us how well service providers are working as opposed to the impact on whole populations From ends to means... From talk to action... OUTCOMES A condition of well-being for children, adults, families or communities INDICATORS A measure which helps quantify the achievement of an outcome ENDS PERFORMANCE MEASURES A measure to evaluate how well a programme, agency or service system is working MEANS 7

8 Population and Performance Accountability OUTCOME: All Young People in (a place) are Healthy Young people attending active lifestyle programme All Young People in (a place) WHOLE POPULATION End INDICATOR Obesity Rate Contribution PERFORMANCE MEASURE % Young people attending losing weight Means 1. Safe Communities 2. Crime Rate Outcome, Indicator or Performance Measure? 3. Average Police Response Time 4. Young people making a Positive Contribution 5. First time entrants to Youth Justice System 6. Teenage Conception Rate 7. Social care users treated with dignity & respect 8. Achievement of 5 A*-C grades at GCSE 8

9 Inches of Water The Leaking Roof (Outcomes Thinking in Everyday Life) Experience Measure Not OK Forecast Fixed? Time Story behind the baseline (causes) Partners What Works? Action Plan (Strategy) POPULATION OUTCOME INDICATORS BASELINES STORY Behind the baselines PARTNERS With a role to play WHAT WORKS ACTION PLAN All Adults in [a place] All Adults are Healthy and Successful Measures of the outcome 1. All age, all cause mortality rate current smoking rate 3. Healthy life expectancy at Age 65 The causes, the forces at work What s driving the baselines? Where we ve been Where we re going Where we want to be Public, Private and Voluntary Sector Community groups Residents Data Development Agenda (Pt 1) What would it take to turn the curve? Best practice Data Best hunches Development Agenda (Pt 2) What we propose to do, how and by when 9

10 The 7 Population Accountability Questions 1. What are the quality of life conditions we want for the children, adults and families who live in our community? (Outcomes) 2. What would these conditions look like if we could see them? (Indicators) 3. How can we measure these conditions? (Baselines) 4. How are we doing on the most important of these measures? (The Story Behind the Baseline) 5. Who are the Partners that have a role to play in doing better? 6. What works to do better, including no cost/low cost ideas? 7. What do we propose to do? (Action Plan) Outcome Based Accountability Turning the Curve Exercise A process to get from Talk to Action 10

11 Turning the Curve Exercise 1. Define the POPULATION 2. Select an OUTCOME 3. Decide what hats you re going to wear (Who s missing?) 4. Select an appropriate indicator (how would we recognise our Outcome? ) i. Brainstorm some possible indicators ii. When the list is exhausted, using the prioritisation grid, rate each indicator HIGH, MEDIUM or LOW against the following criteria... Criteria for Selecting Indicators Communication Power Does the indicator communicate to a broad range of audiences? (Does it pass the Town Square test?) Indicators should be common sense and compelling, not arcane and bureaucratic Proxy Power Does the indicator say something of central importance about the outcome? Does the indicator bring along the data HERD? Data Power Is quality data available on a timely basis? 11

12 Criteria for Choosing Indicators Outcome Adult Health & Wellbeing Candidate Indicators Communication Power Proxy Power Data Power Mortality rate Mortality from cancers H M L H M L H M L Smoking prevalence rate Healthy life expectancy H H H Satisfaction with home and neighbourhood Support to live independently H H L Etc. Data Development Agenda (Pt 1) Three Part Indicator List (for each Outcome) Part 1:Primary Indicators 3 to 5 most important measures that say most about the outcomes we re striving towards Part 2:Secondary Indicators Everything else that s any good (Nothing is wasted.) Used to help inform intelligence information Part 3:Data Development Agenda New data Data in need of repair (quality, timeliness etc.) 12

13 Number The Matter of Baselines H M L OK? History (point to point improvement) Forecast Turning the Curve Baselines have two parts: history and forecast Turning the Curve Exercise 5. Speculate on a baseline (e.g. Obesity in Primary School Children) Forecasting Where are we going? OK? Backcasting Where have we been? Time Start with NOW The curve to turn 13

14 Turning the Curve Exercise 6. What is the STORY BEHIND THE BASELINE? What s going on here? What s driving the baseline why is it moving in the direction it is? What are the causes and the forces at work? (Data development agenda 2?) 7. What Works? What would it take to Turn the Curve? Three best ideas including: One no cost, Low cost idea One Off the Wall idea Sharp Edges A process to help select better interventions: SPECIFIC Is it specific enough? LEVERAGE How much difference will it make? VALUES Is it consistent with our personal and community values? REACH Is it feasible and affordable? 14

15 Whole Population Turning The Curve Report The definition of the WHOLE POPULATION we want to impact on (e.g. All young people in Hull or All older people in Middlesbrough etc.) The desired OUTCOME: The condition of well-being we want for our defined whole population The priority INDICATOR we will use to determine progress towards our OUTCOME The INDICATOR BASELINE made up of the historical data, the projected forecast (if nothing is done) and showing the curve we want to turn Key pointers to action The STORY BEHIND THE BASELINE: What we know about the factors driving the baseline. What are the causes/factors at work? What s our best community intelligence on this issue? What are the gaps in our knowledge (our DATA DEVELOPMENT AGENDA)? What do we need to know to inform our action plan? Who are the KEY PARTNERS with a role to play in Turning the Curve? These could be public sector service providers, residents, voluntary and community organisations and businesses amongst others WHAT WOULD IT TAKE TO TURN THE CURVE? What s our best thinking on this, our best hunches? What would work in our community? Always include at least one No Cost/Low Cost idea and an Off The Wall idea (to generate creative thinking) NB: ONE SIDE OF FLIPCHART PAPER ONLY! Outcome Based Accountability Managing and Improving Performance 15

16 Managing Performance using OBA All Performance Measures that have ever existed for any programme in the history of the universe involve answering two sets of interlocking questions. Programme Performance Measures QUANTITY QUALITY How Much did we do? (number) How Well did we do it? (percent) 16

17 OUTPUT EFFECT INPUT EFFORT Programme Performance Measures Effort How hard did we try? Effect Is anyone any better off? Programme Performance Measures QUANTITY QUALITY How much service did we deliver? How well did we deliver it? Cause How much change/effect did we produce? What quality of change/effect did we produce? Effect 17

18 EFFECT EFFORT EFFECT EFFORT School QUANTITY How much did we do? QUALITY How well did we do it? Number of Students Pupil/Teacher Ratio Number of 16 year olds with 5 A to C GCSEs Is anyone better off? Percentage of 16 year olds with 5 A to C GCSEs Number with good school attendance Percentage with good school attendance Health Clinic QUANTITY How much did we do? Number of Patients Treated QUALITY How well did we do it? Percentage of patients treated in less than 1 hour Is anyone better off? Recovery Number/ Rate (%) (for patients of the clinic) 18

19 EFFECT EFFORT EFFECT EFFORT Smoking Cessation Programme QUANTITY How much did we do? Number of clients enrolled Number of courses Number of nicotine patches issued QUALITY How well did we do it? % clients completing programme % counsellors trained to professional standard % clients saying they were treated well Is anyone better off? Number/Percentage smoke free At exit of programme After 12 months Number/Percentage clients saying they were helped to quit smoking Child Foster Care QUANTITY How much did we do? Number of children placed QUALITY How well did we do it? % children placed in same school catchment area % siblings placed together Is anyone better off? Number/Percentage of foster children with good school attendance Number/Percentage of children in permanent placement within 6 months 19

20 EFFECT EFFORT EFFECT EFFORT Employment Counselling Service QUANTITY Number of benefit claimants invited to interview Number of claimants counselled QUALITY Number of claimants saying they were treated with dignity and respect Number of claimants saying they were more committed to finding work Number/Percentage of service users taking up employment within two months Number/percentage of service users still in employment after 12 months Customer Satisfaction QUANTITY QUALITY How much did we do? How well did we do it? Did we treat you well? How much change/effect did we produce? What quality of change/effect did we produce? Did we help you with your problems? (The world s simplest and yet complete customer satisfaction survey) 20

21 EFFECT EFFORT EFFECT EFFORT Not All Performance Measures Are Created Equal... QUANTITY How much did we do? LEAST important QUALITY How well did we do it? Also Very Important Is anyone better off? MOST important The Matter of Control QUANTITY How much did we do? MOST control QUALITY How well did we do it? Is anyone better off? LESS control PARTNERSHIPS We have the least control over the most important matters 21

22 The 7 Performance Accountability Questions 1. Who are our customers? 2. How can we measure if our customers are better off? (Lower Right Quadrant Measures) 3. How can we measure if we are delivering services well? (Upper Right Quadrant measures) 4. How are we doing on the most important of these measures? 5. Who are our partners that have a role to play in doing better? 6. What works to do better, including no-cost and lowcost ideas? 7. What do we propose to do? Performance Turning The Curve Report The programme, service system or project being performance managed The customers: i.e. the people whose lives are affected (for better or worse) by the actions of the programme The priority PERFORMANCE MEASURE derived in particular from the How well and Better Off (right hand quadrant) questions The PERFORMANCE MEASURE BASELINE made up of the historical data, the projected forecast (if nothing is done) and showing the curve we want to turn The STORY BEHIND THE BASELINE: What we know about the factors driving the baseline. What are the causes/factors at work? What is our understanding of what s driving our performance? What are the gaps in our knowledge (our DATA DEVELOPMENT AGENDA)? What do we need to know to inform our action plan? Who are the KEY PARTNERS with a role to play in Turning the Curve? These could be internal departments, service users, suppliers etc. WHAT WOULD IT TAKE TO TURN THE CURVE? What s our best thinking on this, our best hunches? What would work in our organisation? Always include at least one No Cost/Low Cost idea and an Off The Wall idea (to generate creative thinking) 22

23 Identifying Performance Measures The Five Step Method Choosing Performance Measures Upper Left Quadrant How much did we do? Number of customers served (e.g. Adults over 80 years) (e.g. Adults with disabilities) (e.g. Adults from an ethnic minority background) Etc. Number of Activities (e.g. Number of people supported) (e.g. Number of activity sessions) (e.g. Number of newsletters published) Etc. Customers are the people who are affected (for better or for worse) by the actions of the programme or service How much did we do? Is anyone better off? How well did we do it? 23

24 Choosing Performance Measures Upper Right Quadrant How well did we do it? % Common measures (e.g. % Staff turnover rate) (e.g. % Qualified/trained staff) (e.g. % Staff Morale) (e.g. % Customer satisfaction) (e.g. % Unit Cost) % Activity specific measures (e.g. % actions timely and correct) (e.g. % clients completing activity) (e.g. % of actions meeting standards) (e.g. % client satisfaction) How much did we do? Is anyone better off? How well did we do it? Choosing Performance Measures Lower Quadrants Is anyone better off? Expressed as NUMBER (for QUANTITY of benefit) and as PERCENTAGE (for QUALITY of benefit) How much did we do? How well did we do it? Is anyone better off? 24

25 Finding Performance Measures for Benefit Skills/Knowledge e.g. Qualifications e.g. Accreditation e.g. Test scores e.g. Parenting Skills e.g. Knowledge about benefits system Attitude/Opinion e.g. % students expressing high ambition e.g. % customers felt they were helped with their problems Behaviour e.g. School attendance e.g. Tenants paying rent on time e.g. Practising safe sex e.g. Coming off drugs Circumstances e.g. Graduates into decent paid jobs e.g. Tenants in stable housing e.g. In receipt of full benefit entitlement Choosing Performance Measures Lower Quadrants Is anyone better off? Expressed as NUMBER (for QUANTITY of benefit) and as PERCENTAGE (for QUALITY of benefit) Number/percentage (Skills/Knowledge) Number/percentage (Attitude/Opinion) Number/percentage (Behaviour) Number/percentage (Circumstance) How much did we do? How well did we do it? Is anyone better off? 25

26 Identifying Performance Measures: The Five Step Method How much did we do? Number of customers served (by customer characteristic) How well did we do it? % Common Measures Number of Activities (by type of activity) % Activity measures 1 2 Is anyone better off? (Quantity) (Percentage) 3 3 Identifying Performance Measures: The Five Step Method QUANTITY How Much? Number of customers served (by customer characteristic) Measure 1 Measure 2 Measure 3 Number of Activities (by type of activity) Measure 1 Measure 2 Measure 3 Measure 4 Better Off (#) Measure 1 Measure 2 Measure 3 Measure 4 Measure 5 Measure 6 QUALITY How Well? Measure 1 Measure 2 Measure 3 Measure 4 1 Measure 5 DD3 Measure 6 Better Off (%)? Measure 1 DD1 Measure 2 2 Measure 3 Measure 4 3 Measure 5 Measure 6 DD2 4 5 Identify measures with good data Prioritise Identify & Prioritise Data Development measures Headline Measures Secondary Measures Data Development Agenda 26

27 Summary of Performance Measures How much did we do? Number of customers served (by customer characteristic) Number of Activities (by type of activity) How well did we do it? % Common measures Workload ratio, staff turnover rate, staff morale, percentage of staff fully trained, worker safety, unit cost, customer satisfaction: Did we treat you well? Etc. % Activity Specific Measures Percentage of actions timely and correct, percentage clients completing activity, percentage of actions meeting standards etc. Is anyone better off? Number/Percentage Skills/Knowledge Attitude/Opinion Including customer satisfaction Did we help you with your problems? Behaviour Circumstances Outcome Based Accountability More about Using Data and other OBA applications 27

28 Effect Effort Comparing Performance 1. To ourselves first Can we do any better than our own history? 2. To others When it s a FAIR apples/apples comparison Using a baseline, Chart on the Wall Reward? 3. To standards When we know what good performance is Punish? The Matter of Standards Quantity 1. Quality of Effort Standards are sometimes WELL ESTABLISHED Childcare staffing ratios Application processing times Disability access facilities Child abuse report response times BUT 2. Quality of Effect Standards are almost always EXPERIMENTAL Hospital recovery rates Employment placement and AND retention rates Recidivism rates 3. Both require a LEVEL PLAYING FIELD and an ESTABLISHED RECORD of what good performance is. 28

29 Indicator (Units) Advanced Baselines Target or Standard Create Targets only where they are FAIR and USEFUL Avoid publicly declaring Targets by year if possible Your Baseline Comparison Baseline Instead: Count anything better than baseline as progress Timeline (Years) Outcome Based Commissioning Smoking Cessation Programme How much did we do? Number of clients enrolled Number of Courses Number of Nicotine Patches issued Is anyone better off? Number smoke free At exit of programme After 12 months Number clients saying they were helped to quit smoking How well did we do it? % clients completing programme % counsellors trained to professional standard % clients saying they were treated well % smoke free At exit of programme After 12 months % clients saying they were helped to quit smoking 1. You can purchase services. 2. You can purchase service quality 3. You cannot purchase customer outcomes. Instead, you can purchase a contract relationship that maximizes good customer outcomes. Service Specification (Smoking Cessation Programme) The WHOLE POPULATION OUTCOME we re looking to contribute to: People in Newcastle are Healthy The INDICATOR we re trying to influence (the CURVE we want to turn): Number of Smokers in Newcastle (Story behind the baseline) Description of the service including the QUANTITY of service we want to buy We will measure the QUALITY of the service by these performance measures We will work together to maximise the EFFECT of the service demonstrated by these performance measures (Customer Outcomes) 29

30 Effect Effort Next Generation Commissioning Quantity Quality 1. Traditional purchasing methods work fine in the upper quadrants. BUT 2. They break down in the Is anyone better off? quadrants (because of case mix differences and perverse incentives). WHICH MEANS 3. What we purchase in the lower quadrants are not deliverables, but rather a RELATIONSHIP where commissioner and service providers work together to maximize customer/client outcomes. The Three Essential Provisions of Next Generation Commissioning 1. The most important performance measures How much? How Well? Anyone Better Off? The three to five measures that say most about the effectiveness of the service provider s performance* *As determined from the Five Step Method 30

31 The Three Essential Provisions of Next Generation Commissioning 2. Continuous Improvement Process Using Turning the Curve report cards based on the 7 performance accountability questions Using the same basis for management supervision across the organisation The Three Essential Provisions of Next Generation Commissioning 3. Performance Partnership between commissioner and service provider Periodic meetings to review progress on the three to five most importance performance measures (based on Turning the Curve reports) Reviewing changing stories behind the baseline Agreeing measures the commissioner can take to help improve performance as partners in facilitating improvement e.g. Technical assistance and support Brokering relationships with third parties Helping to break down barriers to progress This does not compromise respective accountability: For commissioner s responsibility for service provider s performance and effective use of funds For service provider s commitment to continuous improvement process 31

32 An Outcomes Focused Partnership Agenda 1. New data 2. New stories behind the baselines 3. New partners 4. New information on what works 5. New information on financing 6. Changes to action plan and budget 7. Any other business What s Next? A Basic Action Plan for Outcome Based Accountability Implementation along two parallel tracks: Track One: Population Accountability Establish outcomes Establish indicators, baselines and charts on the wall Create an indicators report card Establish action groups to turn curves Track Two: Performance Accountability Performance measures, and charts on the wall for programs, agencies and service systems Use 7 Questions programme by programme in management, budgeting and strategic planning 32

33 Different Kinds of Progress Report 1. Data a) Population indicators: Actual turned curves - movement for the better away from the baseline. b) Service performance measures: customer progress and better service: How much did we do? How well did we do it? Is anyone better off? 2. Accomplishments: Positive activities, not included above 3. Anecdotes: Stories behind the statistics that show how individuals are better off Outcome Based Accountability Population and Performance Accountability Putting it all together 33

34 Performance Accountability Population Accountability Performance Accountability Population Accountability The Linkage between Population and Customer Outcomes Extract from Sustainable Community Strategy People Feel Safe Anti Social Behaviour Incidences Communities are Prosperous (NI152) Working age people on out of work benefits Young People Succeed Teenage Conception rates POPULATION OUTCOMES etc. ENDS Contributory Relationship Extract from Service Improvement Plan Employment Counselling Service Alignment of Measures Number of benefit claimants invited to interview Number of claimants counselled No. of service users taking up employment within two months No. of service users still in employment after 12 months Number of claimants saying they were treated with dignity and respect Number of claimants saying they were more committed to finding work % service users taking up employment within two months % of service users still in employment after 12 months CUSTOMER OUTCOMES MEANS Appropriate Accountability The Linkage between Population and Customer Outcomes Extract from Community Strategy Thriving Local Economy (NI152) Working age people on out of work benefits Healthy and Successful Adults (NI 123) 16+ current smoking prevalence Stronger Communities (NI 4) % people who feel they can influence decisions Extract from Service Improvement Plan Smoking Cessation Programme Number of clients enrolled Number of courses run Number of nicotine patches issued Number of clients smoke free on completion of programme after 12 months % clients completing programme & clients completing training courses % clients saying they were treated well % of clients smoke free on completion of programme after 12 months POPULATION OUTCOMES CUSTOMER OUTCOMES ENDS MEANS Contributory Relationship Alignment of Measures Appropriate Accountability 34

35 Population Accountability Outcome: to which you contribute to most directly. Indicators: Every time you make a presentation, use a two-part approach Story: Partners: What would it take?: Your Role: as part of a larger strategy. Performance Accountability Service: Performance measures: Story: Partners: Action plan to get better: Wyoming Strategic Planning Design Part 1 To be completed by the Governor s Planning Department Quality of Life Outcome e.g. Clean Environment, Prosperous Economy, Strong Stable Families, Children ready for and succeeding in school etc. Why is this important? Briefly explained in a way that a taxpayer can understand why this quality of life condition is important How Are We Doing? Showing the three to five most important indicators with at least 3 years of actual history The Story Behind the Baselines Explained in a way that a taxpayer can understand what is driving these indicator baselines above. Use additional data as necessary to explain this story What it will take to do better and the role of state government Including no cost, low cost ideas and the role of the state s partners Appendix A: Data Development Agenda (Priorities for new or better indicator data) Wyoming Strategic Planning Design Part 2 Same format for Departments, Divisions and Programmes Department/Division/Programme Contribution towards Quality of Life Briefly explained so a taxpayer could understand how your department in conjunction with other public and private partners contributes to the quality of life of the people in Wyoming Basic Facts Showing total number of staff and size of budget in total and general funds. List the 5 most important programmes or functions and show annual number served Performance Showing the 3 to 5 most important measures with at least 3 years of actual history. Performance measures must be those that best answer the questions: How well are we delivering the service? Are our customers better off? (Customer outcomes) Story behind (last 3 years) performance Briefly explained so a taxpayer could understand the causes behind your performance for the last few years including an explanation of the picture of performance shown above. Use additional data as necessary to tell the story. Best format is short paragraphs with first sentence underlined What do you propose to do to improve performance in the next two years? Include no cost and low cost ideas and the contribution of partners Appendix A: Data Development Agenda (on performance) Appendix B: Link to Budget: Detail on priorities above identified in current or proposed budget Adapted from Trying Hard is Not Good Enough by Mark Friedman 35

36 The OBA Journey From Talk to Action ENDS (POPULATION ACCOUNTABILITY) DESIRED OUTCOME Choosing the INDICATORS Drawing the BASELINE (and the CURVE TO TURN) The STORY BEHIND THE BASELINE REVIEW Choosing the PARTNERS Contributory Relationship The ACTION PLAN PROCUREMENT Deciding WHAT WORKS PERFORMANCE MEASURES How Much? How Well? Better Off? (CLIENT OUTCOMES) MEANS (PERFORMANCE ACCOUNTABILITY) Outcome Based Accountability Hints and Tips David Burnby 36

37 Hints and Tips The bottom line for this work is to turn curves Pick one thing and do it well: don t try to do everything Anywhere leads to everywhere turn one curve and it will have a positive impact on another Develop report cards and make them visible put them on walls or in information bulletins Hints and Tips Be really clear about the difference between population and performance accountability Under population be clear about your role and what you are accountable for When is something a performance measure? when there is a defined population that you can name Practice the skills e.g. filling in the 4 quadrants 37

38 Hints and Tips You deliver services you cannot deliver outcomes don t talk about delivering outcomes talk about improving outcomes Create Outcomes Champions Start the parade others will want to join in An Outcomes Organisation... Understands the population and trends Knows the purpose, mission and vision and where the organisation is going all based on local population needs Is outward facing Uses data to assess how well the organisation is doing 38

39 An Outcomes Organisation... Uses shared language Takes collective responsibility rather than blaming individuals Has incentives for creative thinking Focuses on actions, not just talk Encourages independent thinking and thinking outside of the box An Outcomes Organisation... Has population and performance charts on the wall Has people talking about population and performance and focusing on bottom right measures Successfully makes the move from Talk to Action 39

40 And finally... There is nothing worse than doing something well that shouldn't be done at all. Be effective, and get the right things done Peter F Drucker American Businessman, Author, Speaker 40