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NCHN Spring ConferenceApril 18, 2005

Jill Zabel, ManagerWipfli Health Care Practice

Network Formation, Evolution & Evaluation

Objectives

• Network Life CycleStages & speed of development

• EvaluationA tool for sustainability

Why do networks form?

• Quality Initiatives

• Recruiting• Spread Risk• Education• Referrals• Professional

growth

• Advocacy• Share services• Purchasing• Technology

access• Managed Care

contracting• Grant access

Network Life Cycle

DEVELOPMENT

GROWTH

MATURATION

PERFORMANCE & PROCESS IMPROVEMENT

PLATEAU

STAGNATION & DECLINE

Network Development

• Why?Goal-drivenActivity-driven

• How? InformalFormal

• What?Solid Base Includes

Sustainability & Evaluation

DEVELOPMENT

Network Growth

• Added Objectives• Added Demand• Added Services• Added Members• Added Funding

GROWTH

Network Maturation• Getting There

StrategyMotivationEvaluation

• Staying ThereStrategyMotivationEvaluation

MATURATION

Network Stagnation & Decline

• Why?Shaky purposeWeak developmentChangeConstraintsRelationship

dynamics• Lack of support• Conflicting agendas• Poor communication• LeadershipSTAGNATION &

DECLINE

Network Stagnation and Failure

• Our observances & opinions Lack of focus and discipline in defining the

network’s “business” Fuzzy objectives Network members have different agendas or

strategies Services lack value or relevance Unequal levels of commitment, involvement,

benefit Poor communication, governance,

leadership, execution of strategies

Avoiding Network Stagnation and Failure

• What the research* says Solid business plans Clear Missions and Goal

Statements Compelling need for network Balance between Mission and

Margin A strategic orientation allows

ability to deal with changing environment

* University of Minnesota Rural Health Research Center, Working Paper #31(Jan 2000), #55 (Nov 2004)

Let’s Talk About Evaluation

• To improve• To build organizational

capacity• To empower• To demonstrate value• To provide information for

decisions about programs

Why Evaluate?

Evaluation Reveals Where You Are

DEVELOPMENT

GROWTH

MATURATION

PERFORMANCE & PROCESS IMPROVEMENT

PLATEAU

STAGNATION & DECLINE

Program Evaluation

• Is NOT about proving the success or failure of a program.

• Think about what you need to know to make program decisions

• What’s working and what is not?• How well are you delivering

value to stakeholders?• What do your members,

stakeholders, customers and funders need to know?

Basic Evaluation

PROCESS OUTCOMESINPUTS

Resources

•Money

•Facilities

•Clients

•Staff

How the program is carried out. What do you do?

•Members share benefits

•Patients served

OUTPUTS

Units of measurement

•Number of members

•Number of people served

Impact of program

•Money saved

•Education

•Patients or members receiving services

There is no set recipe for evaluation…

Evaluation Approaches

• Goals-basedAre you meeting your overall objectives?

• Process-basedHow does your program really work?

Strengths? Weaknesses?• Outcomes-based

What are the benefits for members? Patients?

All or some approaches can be useful

Evaluation Methods

• Questionnaires, surveys• Interviews• Documentation review• Focus Groups• Case Studies

• Internal or External Evaluation

Network Sustainability

• Have a plan• Monitor and measure

• Balance between Margin and Mission

Critical Success Factors for Networks• Strong sense of

mutual ownershipCommon goals among

members

• Clear mission and objectives

• Equitable governance structure

• Adds ValueA clear “value

proposition”

• Strong and consistent communication within network

• Meeting needs not readily available from other sources

Making the Connection

DEVELOPMENT

GROWTH

MATURATION

PERFORMANCE & PROCESS IMPROVEMENT

PLATEAU

STAGNATION & DECLINE

Where are you?

How do you know?

Where do you want to be?

“The advantage of not looking at a map is that you don’t have to admit you’re lost.”

Source: Rural Wisconsin Health Cooperative

Questions? Comments?

For more information about this topic, please contact:

Jill Zabel, ManagerWipfli Health Care Practice4000 Lexington Ave N, Suite 201St. Paul, Minnesota 55126

651.636.6468

jzabel@wipfli.com