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Measuring Services that Help Other Programs Succeed

What are ways to measure services that depend all or partly on others to achieve outcomes? These can be admin or internal services, but not only those; external services can help each other attain outcomes.

By Paul Epstein, Results That Matter Team

This question arose out of my recent experience providing training and assistance to help public health departments start performance management systems.  But I doubt the experience only applies to public health.  In these projects, in which I’ve worked with the Public Health Foundation (PHF), we usually have had state or local health departments organize pilot teams to develop and map goals and objectives that support each other to achieve outcomes, and then develop performance measures.  When one local department asked to use an internal service—purchasing—as a pilot team, I wanted to help that team think of ways to connect their internal administrative function with the public outcomes the department as a whole tries to accomplish.  So, in addition to developing objectives and measures that directly measure purchasing performance, I asked them to consider developing at least one measurable goal or objective that relates to how well they help other programs accomplish their objectives. That seemed to open up their thinking as they proposed doing an internal customer survey and focus some of their measures on things that help move the purchasing process faster so users get the products and services they need on time.  Interestingly, measures included the percent of user requisitions that are properly completed and don’t have to be redone. The purchasing team thought it was their responsibility to train their customers to do it right the first time, so the process can move faster.

This approach turns out to be useful for external as well as internal services.

Based on that initial experience, I included the idea in later projects. I’ve suggested to participants that if they apply our approach to administrative or internal services such as, say, purchasing, HR, or financial management, they should consider developing at least one goal or objective related to how well they help others achieve their objectives.  Then an interesting thing happened.  Teams that work on services that are not completely internal began using this idea, too.  The first to do so was a vital records and statistics group, as they not only serve the public directly, they also serve other government entities and provide data and research assistance to other programs in the health department.  Later, in a department in another state a laboratory services team also used this idea—they also serve a mix of internal and external customers.  But sometimes even programs that seem purely external have used this approach. For example, an immunization team determined that in addition to increasing a range of immunization rates for people of all ages, it was important for them to focus part of their child immunization efforts on helping a separate maternal & child health program achieve its objectives.  

Maybe this idea of considering how your service helps other programs achieve their objectives is a “natural” to catch on in public health.  Because many public health practitioners know that the public’s health cannot be improved by the efforts of health department programs alone. They know that collaborations across department programs and with external partners are needed to achieve outcomes.  But effective partnerships are also required to achieve many other kinds of important public outcomes.  That’s the premise of our Community Balanced Scorecard  (CBSC) methodology. Whether or not the idea is introduced as part of a collaborative strategy management system such as CBSC, as part of a performance management system as in our PHF projects, or separate from a system development effort, I expect it is useful for many if not most public services. It should work whenever the public staff involved want to achieve outcomes and they understand that they need collaboration of others to do so, or that an important part of their role is to help others achieve outcomes.

What do you think of this approach of asking public managers and staff not just to measure their program directly, but also consider how their efforts help others achieve their objectives when they develop performance measures?  What other approaches have you used to measure services that depend all or partly on others to achieve outcomes, whether these are internal or external services?

Please post your thoughts on this LinkedIn discussion on this topic.