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Outcomes and Program Outcomes and Program Improvement:Improvement:
Designing Effective Evaluations Designing Effective EvaluationsPresented by
Christine A. Ameen, Ed.D.Ameen Consulting & Associates
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ReflectionReflection
“If you don’t know where you’re going, you’ll end up somewhere…”
- Yogi Berra
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Some “Reasons” for Doing Some “Reasons” for Doing Outcome Evaluation...Outcome Evaluation...
• I need to be able to fill out these forms that the state department gave me.
• I need a plan for a grant I’m writing.
• I need to get my agency accredited.
• I need to show outcomes for the grant project we just completed.
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Other Reasons for Doing Other Reasons for Doing Outcome Evaluation...Outcome Evaluation...
• Our staff needs to know the impact they make
• Our agency needs to know the impact it makes
• Our funders need to see the return on their investment
• Our accrediting body needs to see evidence of our intent to provide quality services
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The #1 Reason for Doing The #1 Reason for Doing Outcome Evaluation...Outcome Evaluation...
Our clients
deserve the very best service!
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How effective is your How effective is your program?program?
Let me tell you about the kids that are in my group!
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How effective is your How effective is your program?program?
Here’s what’s working…Here’s what we’re learning…Here’s how we’ve increased
effectiveness…
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What is Continuous Program What is Continuous Program Enhancement (CPE)?Enhancement (CPE)?
• A commitment to ongoing assessment of service delivery and client outcomes to achieve the best outcomes possible.
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CPE assumes that:CPE assumes that:• Every program has strengths and weaknesses, and
opportunities for improvement
• The organization values learning
• Administrators nurture a climate of trust and welcome feedback
• Staff want clients/customers to be successful
• Staff are open to learning new and different ways of providing service
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Determining PurposeDetermining Purpose
• Assess the impact of a program
• Improve program implementation
• Identify unmet client needs
• Respond to accountability.
CPE may be used to:
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• Its purpose is clearly understood by everyone
• The organization’s environment is a risk-free learning environment where a climate of trust is nurtured and feedback is welcomed
• Internal collaboration is encouraged and expected.
Adapted from Brinkerhoff, R.O.; Brethower, D.M.; Hluctyl, T.; and Nowakowski, J.R. Program Evaluation: A Practitioner’s Guide for Trainers and Educators. Boston Kluwer-Nijhoff, 1983.
You’re ready if:You’re ready if:
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• Results will be shared with those who have a right to know
• The results will be useful and used
• The process of doing CPE is humane
• The benefits of the CPE justify the cost.Adapted from Brinkerhoff, R.O.; Brethower, D.M.; Hluctyl, T.; and Nowakowski, J.R. Program Evaluation: A Practitioner’s Guide for Trainers and Educators. Boston Kluwer-Nijhoff, 1983.
You’re ready if:You’re ready if:
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Don’t Ask a Question for Which Don’t Ask a Question for Which You Don’t Want the Answer!You Don’t Want the Answer!
• Respond to the results
• Be prepared to learn that perceptions don’t always reflect reality
• Accept the fact that CPE is an innovation and there will be some natural resistance to it
• Be patient — CPE will take some time before its payoffs are realized
You must get administrative buy-in first!
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Planning for CPEPlanning for CPE
1. A program model which describes the services for delivering services to clients and the outcomes clients should achieve
2. An objectives model which defines objectives for the services and objectives for the outcomes
3. An evaluation model which defines how data will be collected and used to monitor the attainment of process objectives and outcome objectives.
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The Processes Used to The Processes Used to Develop the CPE ModelsDevelop the CPE Models
1. Review contracts, licensing agreements, program proposals for service requirements, information requirements and pre-determined outcomes
2. Assess what information needs or concerns board members, administrators, staff, clients, customers, volunteers, policy-makers and public-at-large may have about the program
3. Convene a work group of staff and administrators to develop the CPE models and support implementation
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Building Your Program Building Your Program ModelModel
Defining Program Services and Client Outcomes
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Defining Your Program: The Program Defining Your Program: The Program ModelModel
CLIENT CONDITIONS
PROGRAM SERVICES
CLIENT OUTCOMES
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Some DefinitionsSome Definitions
Client Conditions - demographic characteristics and other factors that describe client need, assets and client risk for not being successful in program
Program Services - the services delivered to address client needs and risks
Client Outcomes - a desired effect or impact of a service, intervention or experience on a client
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Residential Program ModelResidential Program Model
CLIENTCONDITIONS
PROGRAMSERVICES
CLIENTOUTCOMES
Experienced abuse and/or
Had difficulty in school
Experienced disruption inplacement at home
Suffering from depression,low self-esteem
Engaged in delinquentbehavior
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Residential Program ModelResidential Program Model
CLIENTCONDITIONS
PROGRAMSERVICES
CLIENTOUTCOMES
Experienced abuse and/orneglect
Had difficulty in school
Experienced disruption inplacement at home
Suffering from depression,low self-esteem
Engaged in delinquentbehavior
1. Assessment and treatmentplanning
2. Frequent visitation of clientwith family
3. Safe environment in whichto live
4. Attendance at school5. Family therapy6. Individual and/or group
therapy7. Other support services as
needed
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Residential Program ModelResidential Program Model
CLIENT CONDITIONS
PROGRAM SERVICES
CLIENT OUTCOMES
Experienced abuse and/or neglect
Had difficulty in school
Experienced disruption in placement at home
Suffering from depression, low self-esteem
Engaged in delinquent behavior
1. Assessment and treatment planning
2. Frequent visitation of client with family
3. Safe environment in which to live
4. Attendance at school 5. Family therapy 6. Individual and/or group
therapy 7. Other support services as
needed
Resolution of negative legal issues
Avoidance of negative legal issues
Establishment of permanency goal per plan
Movement to a less restrictive, home-based placement
Academic achievement Employment skills Increased ability to manage
emotional functioning Self-care skills Increased pro-social
behavior Sustained effects up to six
months
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A Conceptual Framework for A Conceptual Framework for Behavior ChangeBehavior Change
1. Awareness: the initial consciousness, perception, or sense of a concept
2. Knowledge/Skills: understanding, comprehension of a concept; demonstration of ability of that understanding or comprehension
3. Behavior: performance or conduct in a specified way
4. Modeling behavior: demonstration of specified behavior to others, most often to teach the behavior to others.
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How Far Does Your Program Go?How Far Does Your Program Go?
• How long are clients in the program?
• How intense is the program?
• How extensive is content covered in the program?
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Defining Your Program: The Program Defining Your Program: The Program ModelModel
CLIENT CONDITIONS
PROGRAM SERVICES
CLIENT OUTCOMES
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Building Your Objectives Building Your Objectives ModelModel
Defining Objectives for Services and Outcomes
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Your Program Objectives ModelYour Program Objectives Model
CLIENT CONDITIONS
SERVICES OBJECTIVES
OUTCOMES OBJECTIVES
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Some DefinitionsSome Definitions
Service Objective - a specific statement about how the service is to be delivered, usually including a timeframe and benchmark
Outcome Objective - a specific statement about how much desired effect or impact of a service is going to be achieved.
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Establishing Objectives Establishing Objectives for Program Servicesfor Program Services
• What clients?
• What services will be provided or experienced?
• During what time frame?
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Examples of Service ObjectivesExamples of Service Objectives
100% of clients served will have written treatment plans within 30 days of intake
85% of clients served will have weekly visits with their families throughout their treatment stay
85% of clients will attend school 90% of the time throughout their treatment stay
100% of clients will attend all individual therapy sessions designed in their treatment plans throughout their treatment stay
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Establishing Objectives Establishing Objectives for Client Outcomesfor Client Outcomes
• Desired effect or impact
• On whom or what
• The specific outcome
• By how much, when.
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Writing Client Outcome ObjectivesWriting Client Outcome Objectives
Desired effect Increase, decrease, maintain, reduce, improve…
On Whom Child, children, family
Specific Outcome Ability, skill, knowledge, likelihood of, understanding of
How much, when Percent, number
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Examples of Client OutcomesExamples of Client Outcomes
No youth served will experience recurrence of abuse/neglect while in care.
75% of youth will increase their academic level of functioning by at least one grade level upon release from the program.
No more than 15% of youth completing treatment will be arrested within six months of release from the program
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Residential Program Objectives ModelResidential Program Objectives ModelCLIENT CONDITIONS
SERVICE OBJECTIVES
OUTCOMES OBJECTIVES
Experienced abuse and/or neglect
Had difficulty in school
Experienced disruption in placement at home
Suffering from depression, low self-esteem
Engaged in delinquent behavior
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Residential Program Objectives ModelResidential Program Objectives Model
CLIENT CONDITIONS
SERVICE OBJECTIVES
OUTCOMES OBJECTIVES
Experienced abuse and/or neglect
Had difficulty in school
Experienced disruption in placement at home
Suffering from depression, low self-esteem
Engaged in delinquent behavior
1. 100% of clients served will have written treatment plans within 30 days of intake
2. 85% of clients served will
have weekly visits with their families throughout their treatment stay
3. 85% of clients will attend
school 90% of the time throughout their treatment stay
4. 100% of clients will attend
all individual therapy sessions designed in their treatment plans throughout their treatment stay
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Residential Program Objectives ModelResidential Program Objectives ModelCLIENT CONDITIONS
SERVICE OBJECTIVES
OUTCOMES OBJECTIVES
Experienced abuse and/or neglect
Had difficulty in school
Experienced disruption in placement at home
Suffering from depression, low self-esteem
Engaged in delinquent behavior
1. 100% of clients served will have written treatment plans within 30 days of intake
2. 85% of clients served will
have weekly visits with their families throughout their treatment stay
3. 85% of clients will attend
school 90% of the time throughout their treatment stay
4. 100% of clients will attend
all individual therapy sessions designed in their treatment plans throughout their treatment stay
1. No youth served will experience recurrence of abuse/neglect while in care.
2. 75% of youth will increase
their academic level of functioning by at least one grade level upon release from the program.
3. No more than 15% of youth
completing treatment will be arrested within six months of release from the program
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Your Program Objectives ModelYour Program Objectives Model
CLIENT CONDITIONS
SERVICES OBJECTIVES
OUTCOMES OBJECTIVES
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Building Your Evaluation Building Your Evaluation PlanPlan
Defining Data Collection to Monitor the Attainment of
Service and Outcome Objectives
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Your Program Evaluation ModelYour Program Evaluation Model
SERVICE/OUTCOME OBJECTIVES
DATA COLLECTION PLAN
DATA UTILIZATION PLAN
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Data Collection Plan for the ObjectivesData Collection Plan for the Objectives
Create a data collection plan that includes:
• Information source
• Measurement method
• Timeline for when collected
• Identification of parties responsible for data
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Some Issues to Resolve Related to Some Issues to Resolve Related to Service Objectives DataService Objectives Data
• Service objectives usually report the status of service delivery or the status of the client at a specific point in time
• Attendance versus participation
• Opportunity to participate versus actual participation
• Using currently existing data, e.g., rating forms, attendance records, incident reports, etc.
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Some Common Methods forSome Common Methods forCollecting Outcome Objectives DataCollecting Outcome Objectives Data
• Formal testing or assessment, e.g., vocational skills
• Attitude measurement, e.g., empathy
• Surveys, e.g., therapeutic environment
• Interviews, e.g., follow up with the family upon the youth returning home
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Data Collection for OutcomesData Collection for Outcomes
• Use both qualitative and quantitative information:
• Qualitative
Used when the program is aimed at individualized outcomes
• Quantitative
Used when the program is aimed at common outcomes for all participants
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Some Issues to Resolve Related to Some Issues to Resolve Related to Outcome Objectives DataOutcome Objectives Data
• Will service delivery result in the impact on the client?
• Will service delivery result in the client being able to maintain a positive impact after leaving the program?
• An increase or a decrease in something, e.g., empathy, requires the measure be used at the beginning and the end of the program
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Some Issues to Resolve Related to Some Issues to Resolve Related to Outcome Objectives DataOutcome Objectives Data
• The achievement of a specific level of an outcome, e.g., the family will be able to name 3 community resources they can utilize, requires the measure be used at the end of the program only
• Will instruments such as surveys be read to clients? If read to some, read to all
• Instruments should be administered by staff with whom client have limited or no interaction, to reduce the potential, unintended bias of client responding based upon the relationship to the staff administering the instrument
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Some Tips for Selecting MeasuresSome Tips for Selecting Measures
• Does the instrument directly measure the target behavior or issue the program is intended to change?
• Is the instrument able to measure change?
• Is the instrument appropriate for the population?
• Can the instrument be used in ways that are respectful of the clients and the program?
• Can the instrument be used consistently?
• What is the reading level?
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Data Utilization for the ObjectivesData Utilization for the Objectives
Create a data utilization plan that includes:
• Who will review the data
• How data will be interpreted
• Timeline for when reviewed
• How data will be used
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Some Tips for Writing the Data Utilization Some Tips for Writing the Data Utilization PlanPlan
• Plan on including direct service staff in the review and utilization process
• Results will be interpreted against the benchmark you set for each objective
• Try to anticipate how the information will be used.
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Some Tips for Writing the Data Utilization Some Tips for Writing the Data Utilization PlanPlan
• Review often enough to allow for changes to be made if the objectives aren’t met
• Consider reviewing data about service objectives on a monthly basis
• Consider reviewing data about outcome objectives on a quarterly basis
• Consider reviewing all of the data on an annual basis, to consider setting new benchmarks or new objectives
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Residential Program Evaluation ModelResidential Program Evaluation Model
SERVICE/OUTCOME OBJECTIVES
DATA COLLECTION PLAN
DATA UTILIZATION PLAN
1. 100% of clients served will
have written treatment plans within 30 days of intake
2. 85% of youth will move to a
less restrictive setting upon release from the program.
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Residential Program Evaluation ModelResidential Program Evaluation Model
SERVICE/OUTCOME OBJECTIVES
DATA COLLECTION PLAN
DATA UTILIZATION PLAN
1. 100% of clients served will
have written treatment plans within 30 days of intake
2. 85% of youth will move to a
less restrictive setting upon release from the program.
Intake manager will enter treatment plan date into computer record upon completion of the plan. Discharge manager will enter post placement data into the computer record upon discharge of the client.
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Residential Program Evaluation ModelResidential Program Evaluation Model
SERVICE/OUTCOME OBJECTIVES
DATA COLLECTION PLAN
DATA UTILIZATION PLAN
1. 100% of clients served will
have written treatment plans within 30 days of intake
2. 85% of youth will move to a
less restrictive setting upon release from the program.
Intake manager will enter treatment plan date into computer record upon completion of the plan. Discharge manager will enter post placement data into the computer record upon discharge of the client.
On a monthly basis, program manager will review treatment plan completion rate against the standard. Quarterly review of the rate will be conducted by the CQI committee. Staff will manage to the objective. On a quarterly basis, program manager will review post placement discharge rate against the standard. Quarterly review of the rate will be conducted by the CQI committee. Staff will manage to the objective.
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Your Program Evaluation ModelYour Program Evaluation Model
SERVICE/OUTCOME OBJECTIVES
DATA COLLECTION PLAN
DATA UTILIZATION PLAN
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Where do I start?Where do I start?
• Rome wasn’t built in a day! Focus on 2-3 key services and 2-3 outcomes.
• Don’t reinvent the wheel! Use available resources, beg, borrow and “steal”
• Don’t go it alone! Get together with colleague agencies to learn from one another, pool resources
• Don’t wait for perfection! Measuring outcomes is an involving field
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Why Quality Improvement Efforts?Why Quality Improvement Efforts?
• We need to provide the highest quality services possible
• We need to learn what’s working and what isn’t
• We need to let our staff know how effective our services are
• We need to be accountable to our funders
• We need to make a difference
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Thank you for attending my Thank you for attending my session today!session today!
If you have any feedback for how I can improve my training style or content, please email me your
suggestions!