OUTCOME LESSONSOUTCOME LESSONS

REGINALD CARTERREGINALD CARTERIn-Service Continuing Education In-Service Continuing Education

ProgramProgramNational Peer to Peer TrainingNational Peer to Peer Training

Baltimore Maryland, September 25, Baltimore Maryland, September 25, 20072007

LESSONSLESSONS

• I have learned seven lessons over I have learned seven lessons over the past thirty-three years of the past thirty-three years of implementing a client outcome-implementing a client outcome-oriented management approach to oriented management approach to human service programs including human service programs including nursing home care. nursing home care.

CARTER’S SEVEN CARTER’S SEVEN QUESTIONSQUESTIONS1.1. How many clients are you serving?How many clients are you serving?2.2. Who are they?Who are they?3.3. What services do you give them?What services do you give them?4.4. What does it cost?What does it cost?5.5. What does it cost per service delivered?What does it cost per service delivered?6.6. What happens to the client as a What happens to the client as a

result of the servicesresult of the services??7.7. What does it cost per result?What does it cost per result?

• These seven questions plus Fred These seven questions plus Fred Richmond’s two questions on ROI are Richmond’s two questions on ROI are the basis for the Results Oriented the basis for the Results Oriented Management and Accountability Management and Accountability system used in the national training system used in the national training program and for many of the HUD program and for many of the HUD grants.grants.

• Question number six has always Question number six has always been my favorite because it is the been my favorite because it is the hardest one to answer.hardest one to answer.

LESSON 1LESSON 1

• A client may be receiving your A client may be receiving your service for a short period of time but service for a short period of time but the impact of your service may only the impact of your service may only become obvious long after they have become obvious long after they have left your program.left your program.

• They are always your client.They are always your client.

LESSON 2LESSON 2

• Program managers prefer not to articulate Program managers prefer not to articulate expected outcomes and they develop a expected outcomes and they develop a number of reasons why it cannot or should number of reasons why it cannot or should not be done.not be done.

• You need to be aware of these and be You need to be aware of these and be ready to convince them otherwise.ready to convince them otherwise.

• Resistance to leadership direction is Resistance to leadership direction is common and requires constant clear common and requires constant clear messages regarding expected results.messages regarding expected results.

• The best book on overcoming The best book on overcoming resistance is Ferdinand Fournies resistance is Ferdinand Fournies Why EmployeesWhy Employees Don’t do What Don’t do What They are Suppose to DoThey are Suppose to Do and and What to Do About itWhat to Do About it (McGraw-Hill, (McGraw-Hill, 1999).1999).

LESSON 3LESSON 3

• It is much easier to implement It is much easier to implement outcome management if your boss outcome management if your boss also believes in outcomes.also believes in outcomes.

LESSON 4LESSON 4

• Be skeptical of the accuracy and Be skeptical of the accuracy and consistency of program information – consistency of program information – including federal compliance including federal compliance requirements like reporting using the requirements like reporting using the National Performance IndicatorsNational Performance Indicators

LESSON 5LESSON 5

• Workers underestimate their positive Workers underestimate their positive impact on the lives of clients they impact on the lives of clients they serve.serve.

LESSON 6LESSON 6

• The public is hungry for transparency The public is hungry for transparency and outcome information and and outcome information and expects agencies to tell the truth expects agencies to tell the truth about a program’s success.about a program’s success.

• The fear of sharing low program The fear of sharing low program outcomes is largely unfounded.outcomes is largely unfounded.

LESSON 7LESSON 7

• The biggest untapped potential The biggest untapped potential benefit from sharing worker specific benefit from sharing worker specific outcome information is telling the outcome information is telling the worker how good they are. worker how good they are.

• Left to their own conclusions most Left to their own conclusions most human service workers human service workers underestimate their impact and underestimate their impact and suffer low morale.suffer low morale.