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Building an Organizational Evaluation Infrastructure / Culture to Improve the Management and Outcomes of Health Programs

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Building an Organizational Evaluation Infrastructure / Culture to Improve the Management and Outcomes of Health Programs Judith Hager, MA, MPH Molly Bradshaw, MPH – PowerPoint PPT presentation

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Title: Building an Organizational Evaluation Infrastructure / Culture to Improve the Management and Outcomes of Health Programs


1
Building an Organizational Evaluation
Infrastructure / Culture to Improve the
Management and Outcomes of Health Programs
Judith Hager, MA, MPH Molly Bradshaw,
MPH Geraldine Oliva, MD, MPH Family Health
Outcomes Project University of California, San
Francisco October 24, 2001
2
An Evaluation Infrastructure
  • An institutional philosophy / ethic to provide
    quality, relevant, cost effective services
  • Shared systematic approach / framework
  • Staff with an understanding of and basic
    evaluation skills
  • Access to evaluation resources (tools,
    Information, data, etc.)

3
Why an Evaluation Infrastructure
  • A Formal System of Accountability
  • Influence External Decision Making
  • Assist Program Management Decisions
  • How to best use resources, improve client and
    staff satisfaction
  • Promote team-building

4
Evaluation Is
  • The systematic investigation of the quality and
    effectiveness of organized efforts or activities
  • The systematic assessment of the merit, worth, or
    significance of an object (CDC)

5
A Program is
  • Any organized set of activities intended to
    achieve an outcome
  • (supported by resources)
  • Can be an Initiative, Departmental Program or a
    Project

6
Three approaches to building an evaluation
infrastructure
  • State MCH Sponsored Evaluation Course
  • Non-profit Community Collaboration Framework
  • County Health Department capacity-building

7
MCH Evaluation Course for County MCH Teams
  • Two workshop days / county teams
  • Choose and develop a real program to
    evaluate
  • Technical assistance by phone or on-
    site
  • Assignments and feedback

8
Solano Coalition for Better Health - (5013C)
  • Comprised of hospitals, health plans, health
    depart., CBOs, comm. Clinics
  • Contract for development /
    facilitation / data collection analysis
  • Three goals / comm. health indicators
  • Agree to share info

9
Mendocino County Health Department
  • Mandate for all Division/program managers
  • Philosophy of program improvement / resource
    allocation
  • 2 day workshop
  • Develop evaluations /group critique
  • Manuals / train the trainers

10
Elements of An Evaluation Infrastructure
  • Mandate
  • Purpose
  • Model/Approach
  • Training
  • Expertise
  • Data Capability
  • Gestalt / Integrated

11
Evaluation Planning Framework (CDC)
Engage Stakeholders
Describe the Program
Ensure Use Share Lessons Learned
Focus the Evaluation Design
Justify Conclusions
Gather and Analyze Evidence
12
Creating and Using a Logic Model
  • Purposes
  • Understand the program,
  • how it works,
  • desired results and
  • Test logic

13
More about why.
  • Examine / improve broad, fuzzy objectives
  • Show the chain of events linking inputs to
    results
  • Clarify difference between activities and
    outcomes
  • Identify gaps in logic / assumptions
  • Help determine what to evaluate / key ?s
  • Build understanding consensus about the program

14
Building a Logic Model
  • Evaluation logic models
  • depict how a program works to achieve its
    intended outcomes
  • may be a flow chart, table, diagram, etc
  • have common elements

15
Elements of an Evaluation Logic Model
  • Inputs (resources)
  • Activities (interventions)
  • Outputs
  • Outcomes (short, intermediate and long-term)
  • Some models also include other elements such as
    problem statement, assumptions, environment and
    program target (e.g., 13 to 17 year olds / age,
    sex, location)

16
Today, we will use an adaptation of the UWEX
logic Model
  • A graphic representation that shows logical
    relationships between inputs, outputs and
    outcomes relative to a situation
  • Elements
  • Problem statement/ situation
  • Inputs
  • Outputs
  • Outcomes
  • Assumptions
  • Environment

Ellen Taylor-Powell, University of Wisconsin -
Extension
17
Program Logic Model Preparation
  • Problem Statement
  • Program Description
  • Goals and Objectives
  • Stakeholders / Use of Evaluation
  • Program concepts / action theory
  • Literature Review

18
S I T U A T I O N
INPUTS
OUTCOMES
OUTPUTS
ASSUMPTIONS (Theories that guide your
program) 1. 2. 3.
ENVIRONMENT (external factors)
19
What it tells us
INPUTS
OUTPUTS
OUTCOMES
Programmatic investments
Short
Inter- mediate
Long term
Activities
Participation
Effort / What program does
Who program targets
Resources allocated
With what results
20
PLANNING
OUTPUTS
OUTCOMES
INPUTS
Programmatic investments
Short
Medium
Long term
Participation
Activities
EVALUATION
21
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24
Logical Linkages Example Series of If-Then
Relationships
  • IF THEN IF THEN
    IF THEN IF
    THEN

Program invests time money
Design parenting curriculum
Parents increase knowledge
Parenting improved
Decrease rates of child abuse
INPUTS OUTPUTS OUTCOMES
25
Program Example
Problem Child Abuse
INPUTS
OUTPUTS
OUTCOMES
Parents increase knowledge of child develop.
Design parent ed. curriculum
Staff
Parents use improved parenting skills
Reduced rates of child abuse neglect
Targeted parents attend
Money
Provide 6 training session
Parents learn new ways to discipline
Partners
26
Where Does Evaluation Fit?
INPUTS
OUTPUTS
OUTCOMES
Design parent ed. curriculum
Parents increase knowledge/ child develop.
Staff
Parents use improved parenting skills
Reduced rates of child abuse neglect
Targeted parents attend
Money
Provide 6 training sessions
Parents learn new ways to discipline
Partners
EVALUATION What do you want to know? What data
do you need?
27
Elements of An Evaluation Infrastructure
  • Mandate
  • Purpose
  • Model/Approach
  • Training
  • Expertise
  • Data Capability
  • Gestalt / Integrated

28
Limitations of an evaluation infrastructure
  • Requires staff commitment / time
  • Difficult to evaluate own work
  • May not support rigorous evaluation
  • Not the answer to management problems
  • Still need access to expertise

29
Recommendations
  • Leadership build trust
  • Develop a common language
  • Introduce evaluation model
  • Provide training

30
Recommendations
  • Build a team approach
  • Provide evaluation tools
  • Allocate time / long term
  • Provide guidelines about
    what is important to evaluate

31
Recommendations
  • Understand Evaluation is Complex
  • Accountability for the denominator population
  • Understand stages of evaluation
  • Know when consultants work best

32
Program Planning and Evaluation
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