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Chapter 2: Measure Program Performance Through Survey Data

Chapter 2 in PDF format

Performance measurement data is useful for:

  • monitoring and improving the quality of services;
  • examining the effect of services on recipients; and
  • providing empirical evidence on which to base program improvements and funding decisions.

The Older Americans Act (OAA) services system consists of many components with complex interrelationships. While a simple, linear model captures only some of this complexity, the diagram on page 2-3 illustrates several aspects of the OAA network that are important to measure. This network logic model consists of inputs, or the underlying mission, enabling funding and other resources on which the network relies. The resources support a range of activities, specifically the process of program operations and service delivery. Outputs consist of those initial results, such as the numbers and characteristics of persons receiving services, the amount of services these individual receive (such as the number of home-delivered meals or other service units), or successful completion of such initiatives as improvement in the efficiency of program operations. Most important is measuring the outcomes or the impact that services have on the well-being of older persons such as remaining in the community and avoiding (or delaying) nursing home placement. This is the primary focus of the performance measures and guidance in this Toolkit.

The findings from performance measurement can help refine and improve many aspects of the service delivery system, as illustrated by the feedback loop in the diagram. Finally, the OAA services system operates in an environment that has a substantial influence on the development and delivery of services for the aging, such as nursing home pre-admission screening requirements and the emphasis on home- and community-based services in state long-term care plans. Considering these contextual factors is essential when interpreting and applying the findings from performance measurement. For example, increasing the length of time older persons live independently in the community can be a function of OAA home- and community-based services. But also influential are the care transition systems of hospitals that may affect post-acute and long-term care placement options and decisions for older persons.

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Monitor Quality and Improve Services

Recipient assessment of services, the primary focus of this Toolkit, is a very important part of measuring program and service quality. The results of surveys provide information on the extent to which people use the service, the quality of the service itself, and self-reported outcomes. For instance, home-delivered meals recipients are able to assess the food in terms of temperature, taste, and smell as well as the timeliness of the delivery, all of which are indicators of the service quality.

The results of recipient surveys can document the impact of services from the service recipients’ perspective, and they may also identify areas in which a change in services would better meet the needs of the recipients.

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Document the Effect of Services on Service Recipients

Most people who work in the field of aging want to know the effect their work has on service recipients’ lives in addition to the number and characteristics of the people served. They want to know if the services have helped older Americans remain in the community, or whether receiving services has helped caregivers support their elderly family members. Selected survey items in the Toolkit ask for self-reported outcomes; for instance, the Transportation Survey instrument includes the item: “Do you get around more than you did before you had this service?”

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Provide Evidence of Effectiveness

An increasing number of funding agencies require periodic reporting of performance measurement data, including program inputs, activities, outputs, and outcomes. A measure of service recipient outcomes (i.e., how those services actually helped the people who received them) along with program outputs (e.g., the number of meals, the number of rides that have been provided, etc.) are often required of funding agencies. The results of surveys will assist agencies to respond to the accountability requirements that often accompany their budget requests. For example, the AoA uses a combination of survey results, incorporating many of the Toolkit measures, and output data in its Congressional budget requests.

Performance Measurement Logic Model

POMP Logic Model

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