Results Based Accountability

1. Results BasedAccountability The Fiscal Policy Studies Institute Santa Fe, New Mexico

2. What is RBA? RBA is a disciplined way of thinking and taking action that can be used to improve the quality of life in communities. It can also be used to improve the performance of programs, agencies and service systems.

3. Population Accountabilityis about the well-being ofWHOLE POPULATIONS For Communities – Cities – Counties – States - Nations Performance Accountabilityis about the well-being ofCLIENT POPULATIONS For Programs – Agencies – and Service Systems Results Accountabilityis made up of two parts:

4. RESULT or OUTCOME A condition of well-being for children, adults, families or communities. Population INDICATOR A measure which helps quantify the achievement of a result. PERFORMANCE MEASURE A measure of how well a program, agency or service system is working. Performance DEFINITIONS Children born healthy Rate of low-birthweight babies Percent of eligible pre-natal clients enrolled in xyz home visiting program.

6. H M L The Matter of Baselines OK? Turning the Curve Forecast History Baselines have two parts: history and forecast

9. Program Performance Measures Quality Quantity How welldid we do it? How much did we do? Effect Effort Is anyonebetter off? # %

10. % Common measures e.g. client staff ratio, workload ratio, staffturnover rate, staff morale, % staff fully trained, % clients seen in their own language,worker safety, unit cost % Activity-specific measures e.g. % timely, % clients completing activity, % correct and complete, % meeting standard % Skills / Knowledge (e.g. parenting skills) # % Attitude / Opinion (e.g. toward drugs) # % Behavior (e.g. school attendance) # % Circumstance (e.g. working, in stable housing) # How well did we do it? How much did we do? # Clients/customers served # Activities Is anyone better off?

11. Quality Quantity How well did we do it? How much did we do? LeastImportant Least AlsoVery Important Effect Effort Is anyone better off? MostImportant Most

12. # of employees who graduated from the ELP who were promoted to a leadership position % of employees who graduated from the ELP who were promoted to a leadership position MDH Leadership Training Quality Quantity How well did we do it? How much did we do? Percent of employees in the ELP who are satisfied with the leadership training program Number ofemployees receiving leadership training Effect Effort Is anyone better off?

13. ONE PAGE Turn the Curve Report: Performance Program: _______________ Performance Measure (Lay definition) PerformanceMeasureBaseline Story behind the baseline --------------------------- Partners --------------------------- Three Best Ideas – What Works1. --------------------------- 2. --------------------------- 3. ---------No-cost / low-cost Action Plan

14. Select 3 to 5 Performance Measuresat each level of the organization 3 - 5 3 - 5 3 - 5 3 - 5 3 - 5 3 - 5 3 - 5

15. How Population &Performance AccountabilityFIT TOGETHER

16. THE LINK Between POPULATION and PERFORMANCE POPULATION ACCOUNTABILITY Result:Minnesotans are healthy Your role: Ensure a highly skilled and stable state public health workforce. PERFORMANCE ACCOUNTABILITY MDH Leadership Training Program Contributionrelationship Percent of employees in the ELP who are satisfied with the leadership training program Number ofemployees receiving leadership training # of employees who graduated from the ELP who were promoted to a leadership position % of employees who graduated from the ELP who were promoted to a leadership position CUSTOMERRESULTS

17. Population Accountability Result: to which you contribute to most directly. Your Role Every timeyou make apresentation, use atwo-partapproach Performance Accountability Program: Performance measures: Story: Partners: Action plan to get better:

18. RBA at MDH • RBA 101 training sponsored by the Governor’s Office July 2012 • RBA 101 for all managers and supervisors November 2012 OPI internal training, consultation, facilitation to: • Executive Leadership Team Consultation • Health Steering Team Consultation • Interested divisions/sections • RBA 101 for Local Public Health and MDH May 2013 • EO requirement for Performance Measures by May 2014

19. Population Accountability Track • MDH activities: • Health Steering Team developed results and indicators for the department • Use of RBA criteria • Communication power • Proxy power • Data power

20. Population Accountability Track • Next steps: • Monitor and communicate the data. Create a dashboard. • What curves need to be turned? • Divisions/Offices encouraged to develop additional indicators, as needed, and engage with community partners to “turn the curve” when appropriate.

21. Performance Accountability Track • Mark’s advice: • Identify performance measures • Simplify reporting • Turn the curve on performance • Post charts on the wall

22. Infrastructure and Support • Mark’s advice: • RBA expert in each unit • RBA Practice Community • Self Assessment Questionnaire • Highlight/communicate RBA success

23. Infrastructure and Support • MDH Activities: • Office of Performance Improvement expertise and support • Intranet resources and library • Train the Trainer - RBA Performance Measure Development

24. Where Does RBA Fit?

25. Where Does RBA Fit?

26. Where Does RBA Fit?

27. Where Does RBA Fit?

28. Resources: Trying Hard is Not Good Enough, Mark Friedman RBA Website: www.raguide.org RBA Monthly Newsletter: http://us5.campaign-archive2.com/?u=fb3578ba8f13ca8294610fc9e&id=20214c10e7&e=1dbc0bff8f Vermont Department of Health: http://healthvermont.gov/hv2020/#toolkit