Betty Bekemeier

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Logic Models
Outcome Measurement
Making sense of what happens as a result of our
efforts
Betty Bekemeier Follow-up iLinc session May 31,
2007
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Ways to Think about Outcome Measurement

• Performance measurement
• Evaluation
• Logic models
• . . .these are not mutually exclusive!

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Why Do We Need to Do This?

• To provide accountability.
• To improve program quality.
• To make decisions about resource allocation.
• To help programs market themselves.
• To understand our contribution to our
  communitys health.

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How Do We Do This?

• Set a goal.
• Define activities.
• Identify inputs or resources.
• Define outcomes.
• Develop outcome measures or indicators.
• Build consensus around these measures.

Activities
Outputs
Outcomes
Goals
Resources
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Logic Models So That Chains
Resources
Outputs
Outcomes
Goal
Activities
So That
So That
So That
So That
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Developing an Outcome Evaluation Logic Model
Process
RESOURCES
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Developing an Outcome Evaluation Logic Model
Process
RESOURCES
ACTIVITIES
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Developing an Outcome Evaluation Logic Model
Process
RESOURCES
ACTIVITIES
OUTPUTS
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Developing an Outcome Evaluation Logic Model
Process
Outcomes
RESOURCES
ACTIVITIES
OUTPUTS
OUTCOMES
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Developing an Outcome Evaluation Logic Model
Process
Outcomes
RESOURCES
ACTIVITIES
OUTPUTS
GOALS
OUTCOMES
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Developing an Outcome Evaluation Logic Model
Process
Outcomes
RESOURCES
ACTIVITIES
OUTPUTS
GOALS
OUTCOMES
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Why a Logic Model?

• A logic model
• Clarifies each program element.
• Shows the relationship of resources and
  activities to expected outcomes.
• Summarizes how program parts relate to the
  whole.
• Makes explicit the theory of how the program
  works.
• Identifies categories to measure in the program
  evaluation.

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Acknowledgements

• Material was used and adapted from
• Organizational Research Services, Inc.
• The Washington State Public Health Nursing
  Directors
• Sponsors are
• NWCPHP
• The Washington State Department of Health
• The federal Health Resources and Services
  Administration (HRSA)

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Example Kitsap County Health District
Integrating the Use of Logic Models into all KCHD
Community Health Programs
Resources
Activities
Goal
Outputs
Outcomes
Number of CH staff trained in logic model
development Number of program staff meetings
allocating time for work on logic models Number
of logic models developed Number of contacts with
NWCPHP for technical assistance with logic model
development Number of outcome measure
consultations with KCHD Epidemiology staff
100 of CH program managers use logic model
outcome measures to annually evaluate program
effectiveness by Dec. 2008 100 of CH Programs
have identified at least two outcome measures
that demonstrate program benefits to the
community by Dec. 2008 90 of all CH staff
receiving logic model training can define the
components of the model and describe at least two
benefits of using this model when surveyed 6
months post training
All CH Programs use outcome measures as an
evaluation tool to guide practice
7 CH staff trained in Logic Model 101 Additional
logic model training is available from NWCPHP
(iLinc) and other sources Technical assistance in
logic model development is available from
NWCPHP KCHD Epidemiology staff are available for
consultation in developing outcome measures
Train all CH staff in logic models Allocate time
at monthly staff meetings for logic model
development, critique and mentoring Use program
logic model as annual work plan Incorporate the
use of logic models into performance expectations
for CH Program Managers

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Example Snohomish Health District Logic Model
Description Prevention of Pertussis in Newborns
Goals
Resources
Activities
Outputs
Outcomes
CME breakfast with peer educator at the staff
meeting for OB and family practice MDs Contact
partners to initiate a new standing order at
Snohomish Co. hospitals for post-partum
Tdap Develop education for providers and
patients Brochures Flyers Worked with IACW Adult
Committee in developing chart for pregnancy and
immunizations
One breakfast meeting with 22 providers
attending Education developed 1 brochure 1
letter 5 flyers for different ethnic
groups Contacted medical directors at 5 hospitals
to discuss the initiation of standing orders for
Tdap Mailed 2000 pregnancy and immunization
charts to OB and family practice MDs in WA
Providers educated about the importance of Tdap
in post-partum women Patients educated through
flyers of the need to get a Tdap vaccine Standing
orders in place in all 5 hospitals that deliver
babies in Snohomish Co. Stronger partnership
with drug representatives in promoting education
of physicians Increased request from
practitioners for pregnancy and immunization
charts
Reduction of pertussis in un- or under-immunized
newborns and infants in Snohomish Co.
Staff D and Gayle Journal articles research and
statistics Existing dept meeting for OB and
family practice MDs in Snohomish Co. Knowledge of
standing order process Hospital medical
directors Drug reps Speaker IACW partnership

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Additional Opportunities

• Session 2 Live iLinc presentation on June 6,
  2007, 100230 am
• Same format as this session further interactive
  support, working through participants logic
  models in process.
• Online module
• 30-minute narrated, web-based module
• http//www.nwcphp.org/outcome