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National Assembly on School-Based Health Care Outcome Training Session . Mary Beth Loucks-Sorrell. The language of outcomes…. goal. outcome. output. milestone targets. result. measurable. short term change. objective. impact. differences. long term change. achievements. benchmark.

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Mary beth loucks sorrell

National Assembly on School-Based Health Care

Outcome Training Session

Mary Beth Loucks-Sorrell


The language of outcomes

The language of outcomes…

goal

outcome

output

milestone targets

result

measurable

short term change

objective

impact

differences

long term change

achievements

benchmark

indicator

input

benefits


Key words

Key Words

  • Accountability

  • Compliance

  • Monitoring

  • Reporting

  • Evaluation


Results mindset for today

Results Mindset For Today

  • Performance

  • Success

  • Supporting

  • Information Use

  • Learning & Verification

(Accountability)

(Compliance)

(Monitoring)

(Reporting)

(Evaluation)


Result thinking

Result Thinking

How you approach work, not a component


Historic shift occurring

Historic Shift Occurring

Investor

Funder

  • distributes funds to the types of organizations that align with Foundation mission

  • solicits and grades proposals based on alignment with guidelines, completeness and clarity

  • sees the proposal as the predictor of project success

  • forgets what you promise and adds demerits for late reports

  • distributes funds to those that clearly contribute to foundation defined results

  • asks three questions:

    • What results are we buying?

    • What are the chances we’ll get them?

    • Is this the best use of our dollars?

  • knows there is a difference between what you write to get the money and how you plan to use it.

  • remembers what you promised, and is focused on their return on investment


Historic shift occurring1

Funder

Investor

Historic Shift Occurring

$25,000 to XYZ Program:

Organize weekly mentoring sessions for up to 500 low-income 7th and 8th grade students in 3 separate middle schools for a 6 month period

$25,000 to XYZ Program:

325 of the 500 students we mentor will be at or above grade level in reading at term end.


Three questions for you

Three Questions for You

  • How do you define success – the results of your services?

  • How do you know for sure when success has been achieved?

  • How do you know, throughout your program, that you have enough time and money left to achieve the success you have defined?


Lace up the boots

Lace up the Boots

Outcomes matter most on the “shop floor”

It took us 30 years to make it simple!

Start with a single program

Leader must be involved


How our foundation clients think

How our Foundation Clients Think

  • What project results are you committed to achieving — meaning outcomes from your efforts?

  • How will you know when your results have been achieved? What information or evidence will you use to verify success?

  • What are the critical project steps and participant milestones you will use to manage to success?


Simple terms we use choose your own

Simple Terms we use, Choose your own

Targets:

  • Specific changes in core participant behavior, condition or status that defines ‘success’ for the program

  • Tangible, verifiable, and within the influence of an implementor

    Milestones:

  • Interim behaviors, condition or status that define progress toward meeting the target.


Where to aim

Where to aim

I have changed!

I see the difference

I keep using it

It worked

I remember

I tried it

  • I like it

I got it

I came

Start


Creating targets

Creating Targets

4 Steps

  • Identify the change in behavior you seek for your core participants

  • Specify the degree of change you consider a success

  • Estimate how many participants will be impacted or changed and by when

  • Express your result in a structured statement


Step 1 identify the kind of change you seek for your core participants

Step 1Identify the kind of change you seek for your core participants

Core Participants

Your Program

Change you Seek

  • Underachieving students

  • Children at risk for disease

  • Uninformed policy makers

  • Students complete high school

  • Children at risk for disease get health needs met

  • Policies support access to healthcare


Step 2 specify how much change is required for you to consider it a success

Step 2Specify how much change is required for you to consider it a success


Mary beth loucks sorrell

Step 2Specify how much change is required for you to consider it a success

  • Examples:

    • Students that complete high school on time and have the financial, social and academic achievement to enter post secondary education

  • Children with asthma, high blood pressure, or diabetes learn to manage their disease correctly

  • Policy change that supports increasing school based health clinics to one per county


Step 3 estimate how many of your participants will change and by when

Step 3 Estimate how many of your participants will change and by when

50

Where to look:

  • Past experience with other participants

  • Level of difficulty of participant

  • New and existing participants

    Make your projection!


Step 4 structuring your target statement

Step 4 Structuring your target statement

  • Single Focus:

  • By December 31, 2012, 350 of the 500 children who have been using the E.R. to manage their chronic disease symptoms, will instead manage those symptoms successfully at home for at least 9 months after receiving support from a school based health clinic.

  • Individualized:

  • 50 of 100 schools enrolled in our advocacy training program will launch at least one successful youth led policy effort to removes a barrier to improved health by September, 30, 2012.

  • Menu Focus:

  • Of the 250 teenagers enrolled in Grades 11-12 at Bedford Valley High School,195 will achieve at least 2 of the following by May 31, 2012:

    • Graduate with their class

    • Successfully complete pre-college testing

    • Submit required financial aid documentation/applications

    • Apply for admittance to 3 or more colleges or universities


How our foundation clients think1

How our Foundation Clients Think

  • What project results are you committed to achieving — meaning outcomes from your efforts?

  • How will you know when your results have been achieved? What information or evidence will you use to verify success?

  • What are the critical project steps and participant milestones you will use to manage to success?


Verifying results

Verifying Results

Verification Sources

  • Existing data or measuring instruments

  • Easy to obtain documents

  • Observations and reports by others OR in some cases self-reported behaviors

  • Multiple weak sources can create a strong verification


How our foundation clients think2

How our Foundation Clients Think

  • What project results are you committed to achieving — meaning outcomes from your efforts?

  • How will you know when your results have been achieved? What information or evidence will you use to verify success?

  • What are the critical project steps and participant milestones you will use to manage to success? Will you have enough time and dollars to finish the job?


Answer is in the room

Answer is in the Room

Make mistakes as fast as you can

mistakes mistakesmistakes


Milestones tracking to success

Milestones – tracking to success

Consider this basic flow of participant milestones (M) that predict success:

M1 Participants show up and commit to the program

M2 Participants engage and begin to benefit

M3 Participants demonstrate initial success

M4 Participants demonstrate stronger success

Target:Participants achieve the program target


Milestones tracking to success1

Milestones – Tracking to Success

Example: A youth led policy and advocacy training initiative that focused on removing barriers to access.

M1 Sign up for program and set policy goals

M2 Demonstrate new skills & use for 1st time within 30 days

M3 Achieve at least one short-term goal within 3 months

M4 Achieve all short-term goals and at least 1 long-term goal within 6 months

Result:Engage a minimum of 50 youth who successfully engage in policy and advocacy efforts with a minimum of 5 actual school level or community level policy changes attributed to their work.


Milestones what makes good ones

Milestones – what makes good ones?

Common Elements:

  • Reflect key achievements as a result of the major activities being undertaken

  • Happen over time – not simultaneously

  • Reflects a ‘response’ or achievement progress in regular intervals

  • Are time bound

  • Defines all key accomplishment that are anticipated prior to the result being achieved for the time period


Putting it all together

Putting it all Together

Senior Citizen Volunteer Program

Day 7

Day 14

Day 21

Day 30

Day 120


Just another evaluation framework right

Just another evaluation framework - right?

  • Evaluation Framework

  • External to program

  • Focus: Assessment of results

  • Understand logic of program delivery

  • Establish measurable objectives

  • Result Framework

  • Imbedded in program

  • Focus: Improving results before assessment

  • Understand predictive milestones

  • Define clear results and targets

  • Considerations

  • Standard of evidence

  • Cost and timeliness

  • Effect on energy

  • Timing of decision


Logic models lost in the translation

Logic Models: Lost in the translation

exhausted?


Mary beth loucks sorrell

What goes in What comes out

Missions/Beliefs

Programs/Services

Goals

Work Plans

Organization

Job Description

Budgets

Data Base

Strategic Planning

Financial Audits

Evaluation

Core Know-How

Result Cards

Targets

Milestones

Key Persons

Result Description

Accounted Costs

Data Use

Strategic Mapping

Energy Audits

Rapid Assessments


Mary beth loucks sorrell

Capacity Building

Capacity Building efforts are intended to strengthen the efficiency or effectiveness of organizations to achieve results for those they serve


Mary beth loucks sorrell

New Capacity

(New Model, Strategic Plan, Programmatic Assessment, Board Training, New Software, Fund Development, etc.)

Capacity Building and Planning

Result Trailfor Organizations & TA Providers

Obtains new capacity

Identifies & updates systems, policies, materials, practices

Implements change & demonstrates ability to successfully use new capacity

Uses new capacity and confirm they are on track to achieve organizational results

Realizes reduced costs or increased revenue

(increased efficiency)

Improves results for those served

(increased effectiveness)


Mary beth loucks sorrell

New Capacity

(New Model, Strategic Plan, Programmatic Assessment, Board Training, New Software, Fund Development, etc.)

Capacity Building and Planning

Result Trailfor State Associations of SBHC

Leadership identified

School District agrees/approves creation of clinic

Acquire Equipment and Space

Health clinic opens and begins to address needs

Students get immediate health care needs met

Clinic confirms improved student health

outcomes


Mary beth loucks sorrell

Convening, Advocacy, Research & Dissemination Piloting

Best Practice Integration

Systems Change

Result Path for Policy, Advocacy, Research

Practice Change

Policy Change

Stakeholders agree to address issue

Best practices defined

Create action plan

Best practices piloted

Propose changes

to decision makers

Best practices defined and packaged

Changes agreed to by

Decision makers

Practitioners agree to adopt best practice

Practitioners integrate best practices

Changes made in policies or resource allocations

Long Term Result

Improved results for populations served

(foundation results)


How does applying a result framework impact board development and engagement

How does applying a result framework impact board development and engagement?

  • Clarity allows you to communicate more effectively what the organization is trying to achieve

  • Helps to identify who/what skills are needed at this stage of development

  • Energy is higher when targets are defined

  • Easier for an organization to determine when to say “No”


Set your board recruitment and engagement targets

Set Your Board Recruitment And Engagement Targets

  • Focusing on what you would like to achieve in the next 2 years, what skill sets are you missing from the board?

  • What are the tasks you can give to the three most effective board members currently on your board to achieve success?

  • What are the first three things you will do when you get back to your community to achieve the success you outlined earlier?


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