Measuring outcomes and managing for results

Public and private health and human service organizations currently face two challenges regarding measuring outcomes and managing for results: demonstrating fiscal and programmatic accountability, and using person and organization outcomes for continuous program improvement. Both managers and program evaluators have attempted to respond to these two challenges through techniques and strategies such as total quality management and improved evaluation utilization techniques. Despite these efforts, three difficulties in measuring outcomes and managing for results are typically reported and involve the lack of: (a) a program evaluation model and measurement methods that clearly delineate organization and individual-referenced outcomes and that meet the dual requirements of increased accountability and continuous program improvement; (b) a program logic model that helps program managers see the relationship among inputs, processes, and outputs and the key roles played by formative feedback and contextual variables in managing for results; and (c) a mechanism to manage for results that includes feedback to service providers, a quality improvement process, and performance standards. The present article discusses strategies to overcome these three difficulties based on the authors' work over the last 6 years with a participatory action research and evaluation project for persons with developmental disabilities. (C) 2003 Published by Elsevier Science Ltd.