BEST START ACTION PLANNING: REALISING OUTCOMES FOR CHILDREN

Document Sample
BEST START ACTION PLANNING: REALISING OUTCOMES FOR CHILDREN Powered By Docstoc
					     BEST START CONFERENCE
   ~ PARTNERSHIP IN PRACTICE ~
     Melbourne, 20th March 2007

  BEST START ACTION PLANNING:
REALISING OUTCOMES FOR CHILDREN
                Tim Moore
     Centre for Community Child Health,
    Murdoch Children’s Research Institute,
          Royal Children’s Hospital
                    OUTLINE
•   Rationale for moving to outcomes-based approach
•   Results-based / outcomes-based accountability
•   Definitions of key terms
•   Outcomes-based framework – outcomes /
    indicators, objectives, strategies and activities
•   Program logic, evidence-based practice and
    evaluation
•   Relationship between national / state and local
    outcomes and indicators
•   Local decision-making and action planning
•   Implications for Best Start
In rearing children, we should have some idea about how we
want our children to turn out:
‘Another way to put it would be to say that we need to begin
with the end in mind. We don’t usually do this when it comes
to rearing children. We pretty much rear them by the seat of
our pants.
We develop strategic plans for so many relatively unimportant
things in our life, … but we don’t take the time to make
strategic plans for the most important things in our lives, our
children. Part of the reason is that we don’t know what we
want our children to be in the end. We may say we want them
to be healthy, to be happy, to be content. But what does that
really mean?’
                               Pollard and Rosenbaum (2002)
  RATIONALE FOR ADOPTING A RESULTS-
  BASED OR OUTCOMES-BASED APPROACH
Why outcomes are important
If we are not clear about the outcomes we are aiming for, then
• we will be less likely to achieve desired outcomes,
• we will be unable to judge the efficacy of the service we
  provide,
• we will be less likely to choose a methodology that is
  known to be effective in achieving desirable outcomes, and
• we may persist with approaches and goals that are not
  achieving anything.
                  RATIONALE (cont)
Confusing means with ends
• Human service providers often focus more on the product
  (ie. service) than the outcome, that is, they think that the
  reason the service exists is to provide support and
  intervention programs to children and parents.
• But that is to confuse the means with the ends: all our
  technical expertise and various forms of service are only a
  means to an end – to make some kind of change in the
  child and family.
• The question is what kind of change are we seeking? And
  exactly how does the services we provide achieve that
  change?
                 RATIONALE (cont)
Funding outputs or outcomes?
• In the face of this uncertainty, governments have funded
  services on the basis of outputs (actual services provided)
  rather than outcomes (what these services achieved).
• However, outputs are not necessarily related to achieving
  desired outcomes: providing families with a certain level of
  service does not guarantee that the service is the one best
  suited to meeting the child and family needs.
• Moreover, this way of funding services continues the
  confusion between means and ends by focusing on the
  service to be provided rather than what the ultimate aims
  are.
       RESULTS-BASED AND OUTCOMES-
              BASED MODELS
•   Outcomes-based approaches ‘start with the end in mind’,
    that is, they begin by identifying the outcomes to be
    achieved and work backwards from there
•   For example, the Results-Based Accountability (RBA)
    model (Friedman, 2005) starts with the desired ends and
    works backward toward the means to achieve them.
•   RBA first describes what a desired result would look like,
    then defines that result in measurable terms, and, finally,
    uses those measures to gauge success or failure.
•   RBA asks and answers three basic questions: What do
    we want? How will we recognize it? What will it take to get
    there?
       RESULTS-BASED AND OUTCOMES-
            BASED MODELS (cont)
What is involved in adopting a results-based or
outcomes-based approach involve?
• Identifying the outcomes sought
• Translating outcomes into specific objectives
• Selecting strategies for achieving these objectives on the
  basis of program logic and evidence-based practice
• Translating strategies into specific activities or programs
• Identifying indicators to measure the progress made
             OUTCOMES-BASED MODEL
           Starting with the end in mind



OUTCOMES       OBJECTIVES   STRATEGIES   ACTIVITIES




INDICATORS
STEP 1: IDENTIFY THE OUTCOMES SOUGHT
• The first step in adopting an outcomes-based approach
  is to ask the question, What do we want for our children?
• Outcomes are desired conditions of well-being for
  children, families, and communities. They answer the
  questions, ‘What is it that we want for children and
  families?’
• Common outcomes include healthy children,
  economically self-sufficient families, and children ready
  to learn.
• Outcomes may focus on children, families and/or
  communities, and are likely to be interdependent:
  positive outcomes experienced by the family serve to
  promote the child outcomes and outcomes achieved by
  the child benefit the family
                     EVALUATION
• Evaluation is the task of working out whether a course of
  action is effective.
• It involves the use of social research procedures to
  investigate systematically the effectiveness of social
  intervention programs, with a view to improving policy
  and practice.
• This distinguishes evaluation from longitudinal research
  which measures what happens to children over time.
• The former must include the latter, but is distinct because
  something has been done to alter a child’s life trajectory.
• There are three distinct types of evaluation: process
  evaluation, impact evaluation and long-term
  evaluation
               EVALUATION (cont)
• Process evaluation involves evaluating the process of
  service delivery, including both what was provided and
  how it was provided
• It addresses two key questions:
  Did we do what we intended to do? (ie. did we deliver
  the services we planned and reach the people we had in
  mind?)
  Did we deliver the services in the manner that we
  intended? (ie. did we use family-centred and strength-
  building practices and establish collaborative partnerships
  with parents?)
• This second question is important because the evidence
  clearly indicates that how services are delivered is as
  important as what is delivered.
                EVALUATION (cont)
• Impact evaluation involves evaluating the immediate
  effect or short-term outcome of an intervention.
• It is conducted at the completion of an intervention, and
  addresses the question of whether the intervention had
  the immediate impact on the recipients that was expected.
• Long-term evaluation involves evaluating whether the
  intervention contributed to desired long-term changes in
  functioning
• It is conducted months or years after the intervention has
  been completed and is the ultimate test of the program’s
  efficacy.
             OUTCOMES-BASED MODEL
                   Forms of evaluation

LONG-TERM
OUTCOMES     OUTCOMES      OBJECTIVES   STRATEGIES    ACTIVITIES




              INDICATORS




LONG-TERM             IMPACT                   PROCESS
EVALUATION          EVALUATION                EVALUATION
               EVALUATION (cont)
• Process evaluation involves evaluating the process of
  service delivery, including both what was provided and
  how it was provided
• It addresses two key questions:
  Did we do what we intended to do? (ie. did we deliver
  the services we planned and reach the people we had in
  mind?)
  Did we deliver the services in the manner that we
  intended? (ie. did we use family-centred and strength-
  building practices and establish collaborative partnerships
  with parents?)
• This second question is important because the evidence
  clearly indicates that how services are delivered is as
  important as what is delivered.
                EVALUATION (cont)
• Impact evaluation involves evaluating the immediate
  effect or short-term outcome of an intervention.
• It is conducted at the completion of an intervention, and
  addresses the question of whether the intervention had
  the immediate impact on the recipients that was expected.
• Long-term evaluation involves evaluating whether the
  intervention contributed to desired long-term changes in
  functioning
• It is conducted months or years after the intervention has
  been completed and is the ultimate test of the program’s
  efficacy.
             OUTCOMES-BASED MODEL
                   Forms of evaluation

LONG-TERM
OUTCOMES     OUTCOMES      OBJECTIVES   STRATEGIES    ACTIVITIES




              INDICATORS




LONG-TERM             IMPACT                   PROCESS
EVALUATION          EVALUATION                EVALUATION
           LEVELS OF ACCOUNTABILITY
There are two types of accountability: population accountability
and performance accountability:
• Population accountability involves a department or
  network of agencies taking responsibility for the well-being
  of the population in geographic area.
• Their job is to create the community, state or national
  partnerships necessary to benefit the whole population,
  whether they are receiving services from programs or not.
• Performance accountability involves a manager or group
  of managers taking responsibility for the performance of a
  program, agency or service system.
• Their job is to provide the best possible service for the
  people using the program.
                                               Friedman (2005)
        NATIONAL, STATE AND LOCAL
        OUTCOMES AND INDICATORS

For a nationally- or state-driven but locally-based
strategies, this means that there should be two levels
of outcomes and indicators:
• National or population level outcomes and
  indicators
• Local or program level outcomes and indicators
The local outcomes and indicators should be logically
connected to the state or national outcomes and
indicators
    STATE / NATIONAL LEVEL

 STATE /       STATE /      STATE /
NATIONAL      NATIONAL     NATIONAL
OUTCOMES     OBJECTIVES   STRATEGIES



POPULATION
INDICATORS



                           Local           Local        Local       Local
                          Outcomes       Objectives   Strategies   Activities




                            Local
                          Indicators



                                       Local Program Level
        LOCAL DECISION-MAKING AND
             ACTION PLANNING
• Most programs that are national- or state-driven but
  locally delivered (eg. FaSCIA’s Communities for
  Children, DHS’s Best Start) allow the local community
  and services to determine what outcomes they want to
  achieve and what strategies and activities they will use to
  achieve them
• Responsibility for identifying these local outcomes and
  carrying out action plans requires local leadership, some
  form of local partnership group, and an agreed process
  for developing, implementing and monitoring action plans
  and outcomes
    STATE / NATIONAL LEVEL

 STATE /       STATE /      STATE /
NATIONAL      NATIONAL     NATIONAL
OUTCOMES     OBJECTIVES   STRATEGIES



POPULATION
                           LOCAL
INDICATORS
                          DECISION-
                           MAKING




                            Local          Local        Local       Local
                           Outcomes      Objectives   Strategies   Activities



                            Local
                          Indicators


                                       Local Program Level
OUTCOMES FOR CHILDREN
 (DHS Office for Children, 2006)
        SELECTING OUTCOMES

DHS Outcomes for Children were selected on
the basis that they were
• of known importance to children,
• relevant to all or most children,
• likely to respond to programs of intervention,
  and
• appropriate for government intervention or
  support.
         DHS OUTCOMES FOR CHILDREN:
                 THE CHILD

• Optimal antenatal and infant     • Adequate exercise and physical
  development                        activity
• Optimal physical health          • Positive child behaviour and
• Adequate nutrition                 mental health
• Free from preventable disease    • Successful in literacy and
                                     numeracy
• Optimal social and emotional
  development                      • Safe from injury and harm
• Healthy teeth and gums           • Pro-social teenage lifestyle and
                                     law abiding behaviour
• Optimal language and cognitive
  development                      • Healthy teenage lifestyle
• Healthy weight                   • Teenagers able to rely on
                                     supportive adults
      DHS OUTCOMES FOR CHILDREN:
              THE FAMILY

• Healthy adult lifestyle
• Parent promotion of child health and development
• Good parental mental health
• Free from abuse and neglect
• Free from child exposure to conflict or family violence
• Ability to pay for essentials
• Adequate family housing
• Positive family functioning
     DHS OUTCOMES FOR CHILDREN:
           THE COMMUNITY

• Safe from environmental toxins
• Communities that enable parents children
  and young people to build connections, and
  draw on informal assistance
• Accessible local recreation spaces, activities
  and community facilities
• Low levels of crime in community
DHS OUTCOMES AND STRATEGIES


 OUTCOMES     OBJECTIVES   STRATEGIES




                           Legislation
 INDICATORS                  Innovations
                                 CHILD First
                                     Reporting
                                         Best Start
             STATE LEVEL

BEST START    BEST START   BEST START
OUTCOMES      OBJECTIVES   STRATEGIES



BEST START                 BEST START
INDICATORS                 PARTNERSHIP



                                         BEST START ACTION PLAN



                            Local            Local        Local       Local
                           Outcomes        Objectives   Strategies   Activities



                             Local
                           Indicators


                                        Local Best Start site
     CCCH COMMUNITY ENGAGEMENT
              RESOURCE
Seven step process
1.   Establishing community leadership
2.   Establishing a vision
3.   Appointing a community links worker
4.   Documenting community demographics
5.   Mapping assets
6.   Identifying community needs
7.   Developing an action plan
  CCCH COMMUNITY EVALUATION
           RESOURCE
• This resource has been designed to enable
  those undertaking community-based early
  childhood initiatives to continually measure,
  evaluate and review their initiatives
• The resource helps evaluate the extent to
  which an initiative is being delivered as
  intended, evaluating the immediate effect of
  the initiative that is being delivered, reflecting
  on what has been learned along the way, and
  the implications for future practice
     CONCLUSIONS AND KEY MESSAGES
• There are good reasons why services, service systems
  and governments should be adopting outcomes-based
  approaches to funding, planning and service delivery
• Outcomes-based approaches start with the end in mind,
  and keep that end in mind at all times
• Professional services are not ends in themselves, but are
  means to an end, namely, improved outcomes for
  children and their families
• The strategies and activities we use to support children
  and families need to be based on program logic and
  evidence-based practice – that is, we need to be clear
  about how what we do contributes to the outcomes and
  objectives that we are seeking
 CONCLUSIONS AND KEY MESSAGES (cont)
• Evaluating how services are delivered is as important as
  evaluating what is delivered
• Selecting local outcomes and identifying local priorities
  should be based on consultations with all local
  stakeholders, and mapping of local demographics,
  resources and services
• Developing and implementing a local action plan requires
  the formation of a local community partnership group
• Ongoing feedback from families is needed to ensure that
  the services provided are meeting their needs and
  delivered in ways that are most acceptable to parents
            DR. TIM MOORE
         Senior Research Fellow
Centre for Community Child Health,
Murdoch Childrens Research Institute,
Royal Children’s Hospital, Flemington Road,
Parkville, Victoria, Australia 3053

Phone:          +61·3·9345 5040
Fax:            +61·3·9345 5900
Email:          tim.moore@mcri.edu.au

Websites:       www.rch.org.au/ccch
                www.ecconnections.com.au

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:8/30/2012
language:Latin
pages:48