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Developing Performance Measures Through a Consultative Process

June 2013

Purpose of the Presentation

To provide an example of transformative use of performance measurement

We will cover. . .

Background on the Accessibility for Ontarians with Disabilities Act

An overview on the development of performance indicators to measure the extent to which the Act is really making a difference

An introduction to a method that can help with the selection of indicators when there are multiple stakeholders

An overview of the monitoring methods

Background on AODA The Accessibility for Ontarians with Disabilities Act, 2005 (AODA)

was adopted to improve accessibility for the 1.85 million people with disabilities in Ontario

The legislation covers five domains:• Customer Service

• Information and Communication

• Employment

• Transportation

• Built Environment

Standards have been development relating to each of those domains

Questions to be Addressed What dimensions (health, education, recreation, etc)

should be considered when developing performance indicators to measure the AODA’s impact on people with disabilities, older adults and their families

Which indicators can best account for the diversity among people with disabilities, older adults and their families (i.e. types of disabilities, degree of disability, age)

Which indicators will best measure quality of life improvements for people with disabilities, older adults and their families

What data collection tools can be used measure the performance indicators over time and with a limited budget

Key Focus

The extent to which the standards have had a positive impact on Ontarians with disabilities, older adults and their families

Developing the Indicators Understanding the ADO Standards

Literature review

Consultation with people with disabilities, older adults and their families

• Out reach through a number of vehicles

• On-line survey with 426 respondents

• Focus groups in Huntsville, Toronto, Ottawa, Thunder Bay and London with a total of 58 participants

• Social media blog with no response

• Submission (1)

Priority Sort process including a rapid sort and a more thoughtful sort

Finalizing indicators

Findings from the Literature

Not agreed-upon definition – subjective to each individual

Schalock and his colleagues developed a framework that focuses on empowerment rather than disability

Canadian Index of Well-being looks at indicators for that cover all Canadians

Quality of Life Research Unit at the University of Toronto’s Center for Health Promotion: “The degree to which a person enjoys the important possibilities of his or her life”

Quality of Life Research Unit, Center for Health Promotion, University of Toronto

Key Elements of a QOL Framework Being: Who One Is

• Physical Being

• Psychological Being

• Spiritual Being

Belonging: Connection with One’s Environment• Physical Belonging

• Social Belonging

• Community Belonging

Becoming: Achieving Personal Goals, Hopes and Aspirations• Practical Becoming

• Leisure Becoming

• Growth Becoming

Findings from the Consultation

Most respondents indicated that most indicators were important

Provision of health care services was considered to be the most important

Gave advice on wording and consolidation of indicators

Based on the findings seven high level indicators and 26 specific indicators emerged

The Priority Sort Process

Want you to know . . .• What Group Priority Sort is

• Why you might use Group Priority Sort (what the benefits are)

• When it is (and is not) appropriate to use Group Priority Sort

What is Priority Sort?

A participatory priority-ranking exercise

It can be used to:

Define the scope of an evaluation

Select performance measures/indicators

Prioritize strategic planning goals

Define a complex concept

What is Priority Sort?

Has small groups of stakeholders or “experts” rank-order specified items

The outputs are:

a) comparative rankings:

b) rich qualitative data; and

c) engaged participants

Evolved out of Q Methodology and produces similar information as Delphi

Overview of Process

The Priority Sort:Two Step Process

Recent Group Priority Sort: Quality of Life Indicators for People with Disabilities

Rapid Sort Outcome

Sample Instructions: Forced Sort

Now it gets more difficult...

Refine your sort so that there are no more than 6 cards in each category

Try to come to agreement about where each benefit should go

Use blank cards to record any other important indicators (do not sort these)

You have 25 minutes

Forced Sort Outcome

Analysis

Benefits of Priority Sort

Informed decision-making;

Enhanced understanding of the topic among participants;

Strengthened community of stakeholders;

Confidence in the process and the resulting decisions; and

An enjoyable and engaging experience for participants.

When to use Priority Sort

Not the right technique if you are exploring a new area that nobody knows much about.

Not a brainstorming exercise.

Priority Sort captures subjective opinions. If you are seeking objective facts, this is not the right method.

The Priority Sort is most useful when there are divergent opinions.

Recommended Indicators

Agreement on the high level indicators• The over-arching indicators are:

• Being treated with dignity• Feeling an integrated part of school, work and the community

• One high level indicator for each Standard• Customer service: Being served in a way that maintains dignity and

supports inclusion• Employment: Have access to employment consistent with experience,

abilities and training• Information: Have access to information• Transportation: Able to get where you need to go, when you need to go• Design of Public Spaces: Able to move independently around the

community

Reduced the 26 indicators to 12

Recommended IndicatorsCustomer ServiceLevel of confidence that health care providers can provide services in a way that takes into account the person’s disability  

• links back to physical being, psychological being and physical belonging in the project’s methodological framework.

Educational institutions provide services in a respectful manner

• links to psychological being, social belonging, practical becoming and growth becoming in the project’s methodological framework.

Emergency response services are provided in a manner that takes into account the person’s disability

• links to physical being, psychological being, and community belonging in the project’s methodological framework.

Recreation/fitness facilities provide services are provided in a way that allow people with disabilities to use and benefit from them

• links to physical being, physical belonging and leisure becoming in the project’s methodological framework.

Recommended Indicators

EmploymentAccommodation is provided in the workplace for people with disabilities

• links to practical becoming in the project’s methodological framework. 

Managers and co-workers at all levels accept and make accommodation for people with disabilities

• links to social belonging and practical becoming in the project’s methodological framework.

Career development opportunities are provided in a manner that accommodates people with disabilities

• This indicator links to psychological being and practical becoming in

the project’s methodological framework.

The Recommended IndicatorsInformationInformation about local warnings/emergencies is available to and can be accessed by people with disabilities

• links to physical being, community belonging and practical becoming in the project’s methodological framework.

Accessibility planning includes input from people with disabilities  

• links to psychological being and community belonging in the project’s methodological framework.

 Websites are designed so that people with disabilities can access them  

• links to social belonging, community belonging, and practical becoming in the project’s methodological framework.

Recommended IndicatorsTransportationPublic transportation, taxis and GO trains are equally accessible for people with disabilities as for people without disabilities

• Links to psychological being, and community belonging in the project’s methodological framework

Design of Public SpacesPeople with disabilities are able to get to stores, community centres and other public facilities

• This indicator links to social belonging and community belonging in the project’s methodological framework

Learnings from this Process People with disabilities are interested in participating in consultations related to

accessibility want to see that the ADO is taking the impact of the AODA seriously.

The most effective recruitment occurred through organizations representing or serving the population

The survey provided an excellent sense of what was important for people with disabilities and supported reaching a large number of people

The face-to-face consultation augmented this understanding plus provided input into acceptable wording.

A large number of people with disabilities have access to the technology required to participate in on-line surveys

The steps taken to accommodate people with disabilities, as part of the consultation process, was noted and appreciated by participants.

It is still challenging to find facilities that are fully accessible

When conducting consultations, it is important to set the parameters in a way that keeps the discussion focused, but does not disrespect the importance of the other issues being raised.

Research Questions

To what extent have there been changes in quality of life as it relates to the five AODA Standards for people with disabilities, older adults and their families?

What impact do the Accessibility Standards have on key areas of daily living areas for people with disabilities, older adults and their families?

Suggested Monitoring Method

On-line survey

Interviews

Use of existing data

Monitoring Cycle

Baseline (2013/14)• Recruit monitoring participants

• Survey administered and analyzed

• Interviews conducted and analyzed

• Existing data analyzed

• Baseline report produced

Interim year (2014/15)• Contact with participants

Second monitoring cycle (2015/16)• Survey administered and analyzed

• Interviews conducted and analyzed

• Existing data analyzed

• Second report produced

Interim year (2016/17)• Contact with participants

Third monitoring cycle (2017/18)• Survey administered and analyzed

• Interviews conducted and analyzed

• Existing data analyzed

• Review indicators to ensure continued relevancy

• Third report produced

Strengths

Builds on the consultation for developing the indicators – people expressed interest in being involved on an ongoing basis

Covers all of the selected indicators

Cost-effective

Multiple lines of inquiry

Able to measure change over time

Able to measure statistical significance of change

Limitations

Participants dropping off from the survey

• Annual contact will help mitigate this

• A small token of appreciation can encourage ongoing participation

Self-selecting so cannot be generalized to the total population

• With a large enough sample size and tri-angulation with other lines of inquiry we can speak to trends

Questions?

Accessibility Directorate of OntarioCharene Gillies: Charene.Gillies@ontario.ca

Cathexis ConsultingMartha McGuire: martha@cathexisconsulting.caMelissa McGuire: melissa@cathexisconsulting.ca