From inputs and processes to
outputs and outcomes
Dr Pietro Micheli
Associate Professor of Organizational Performance
Warwick Business School
Agenda
• Why measure outcomes?
• Case study
• A different performance management approach?
Why measure outcomes?
(Ebrahim and Rangan, 2014)
Outcomes
Outcomes are the benefits or changes for individuals or
populations during or after participating in program
activities.
The outcomes may relate to changes in knowledge, attitudes,
skills, behaviours or condition. They are what participants
know, think or can do; how they behave; or what their
condition is, that is different following the program.
(United Way)
Outcomes
• Defining outcomes:
o who to reach?
o when and how?
o benefits/difference made?
• Measuring outcomes
• Contributing to outcomes – importance of stakeholders
(not only in the public sector)
Measuring outcomes
What to avoid:
Focus on what is easy to measure, and hope for outcomes
Focus only on outcomes, and hope everything else will follow
So:
• Measuring the outcome itself
• Measuring our contribution to the outcome (experimentally)
• Measuring the processes and activities that contribute to the
outcome
• Measuring the contribution of the network of stakeholders
to the outcome…
RQIA Strategic Map 2009 - 2012
VP: RQIA provides independent assurance about the safety, qualit y and availability of health and social care
services in Northern Ireland, encourages continuous improvements in those services and safeguards the rights of
service users.
CA1 Improving Care
We encourage and
promote impr ov ements
in the safet y, qualit y an d
av ailability of serv ices
throug h the regulati on
and rev iew of health and
social care
D1 Engage
effectively with our
stakeholders
CA2 Informing the
Population
CA3 Safeguarding
Rights
CA4 Influencing
Policy
We publicly report o n the
safety, q ualit y and
av ailability of
health and social care
We act to protect the
rights of all people using
health and
social care serv ices
We influence policy a nd
standards in health a nd
social care
D4 Manage our finances
and assets effectively
D6 Plan effecti vely
and acti vely manage
organisational performance
D5 Value and develop
our staff
D7 Manage information
and our information
assets effecti vely
R1 Underpinning
legislation
D3 Use evidence and
research to underpin all our
activities
D2 Maintain a robust
governance framewor k
R2 Organisational
relationships
D8 Optimise the use
of ICT to support our wor k
R3 Finances and
assets
D9 Position RQIA
as a respected,
independent regulator
R4 Skilled, moti vat ed
and experienced staff
Key
VP = Value Proposition
CA = Core Activities
D = Value Drivers
R = Resources
R5 ICT infrastructure
RQIA Strategy Map 2012-15
Vision
Core
Activities
Is Care Effective?
Is Care Compassionate?
Avoiding and preventing harm to patients and
clients from the care, treatment and support
that is intended to help them
The right care, at the right time in
the right place with the best
outcome
Patients and clients are treated with dignity
and respect and should be fully involved in
decisions affecting their treatment, care and
support
Regulation
Review
Monitoring Mental Health Legislation
Registering and inspecting regulated
health and social care services to
maintain and promote quality
improvement
Assuring the quality of health and social
care through a programme of reviews and
hygiene inspections
Inspecting and reviewing mental health and learning
disability services to promote improvement and
safeguard the rights of service users
People
Engaging with our
stakeholders to build
strong relationships and
involvement in our work
Developing and
maintaining a
competent, engaged
and a high
performance
workforce
Independence
Inclusiveness
Integrity
Sustainable Performance
Governance
Information & ICT
Setting strategic direction,
maintaining financial
performance and focusing on
continuous improvement
Promoting and
delivering robust
governance and
accountability
Building and
maintaining effective
and customer-focused
information and ICT
services
Values
Engagement &
Communications
Strategic
Enablers
Strategic
Enablers
Is Care Safe?
Core Activities
Values
Our stakeholders require us to make independent assessments to decide whether care is being provided safely, effectively
and compassionately:
Stakeholder Outcomes
Stakeholder
Outcomes
RQIA is the health and social care regulator in Northern Ireland
We provide independent assurance about the quality of care, challenge poor practice, promote improvement, safeguard the
rights of service users and inform the public through the publication of our reports
Purpose
To be a driving force for improvement in the quality of health and social care in Northern Ireland
Purpose
Vision
Draft RQIA Strategy Map 2015-18
Accountability
Professionalism
Effectiveness
Performance management approach
• Definition of outcomes at higher level, but clear leadership
and execution needed.
• Sufficiently shared vision
• Collaboration
• Data sharing - systems that communicate
• Reviews of projects/programmes together
Measurement as quantification vs. measurement as influence
Measurement to capture what is being measured
vs.
measurement to modify what is being measured
Performance management approach
From
Individual responsibility for
measure / objective
Data: precision and accuracy
To
Clear responsibility, but shared
among partners
Data: precision, accuracy and
breadth
Monitoring and control
Monitoring and influence
Short and mid-term
Long-term
Focus on lagging indicators
Focus on leading indicators