This SIMNA VIC event explored the Department of Health and Human Services Public Health and Wellbeing Outcomes Framework. We were fortunate to hear from one of the authors of the Framework, Vikki Sinnott and from Gordon Conochie, Senior Manager at cohealth who discussed the experience in implementing outcomes measurement against the framework.
Vikki Sinnott works for the Victorian Department of Health and Human Services where she and a small team are responsible for strategic public health and wellbeing planning. We have developed the Victorian public health and wellbeing plan 2015-2019 and the Victorian public health and wellbeing outcomes framework.
Gordon Conochie is a senior manager at cohealth, a community health provider in Melbourne, leading teams working in health promotion and refugee and asylum seeker health. He has previously worked in international development in Cambodia and in the UK focussing on developing government policy regarding health and community care.With increasing interest from the sector in synergies between funder-led and organisational approaches to outcomes frameworks, this event provided a unique opportunity to share knowledge and experiences.
Over 70 attendees packed the room, generously sponsored by Origin Energy, where Vikki kicked off describing the catalyst for the framework being a desire for greater accountability and insight into how health outcomes were being improved for people, “how do we know the whole population is benefiting from investment?”.
A major review of the Health Act some years ago led to new legislation requiring public health and wellbeing planning at state and local government areas levels every four years. The first state level plan was released in 2011; and the second in 2015. An opportunity to formalize an outcomes framework emerged with the second plan, as an alternative to evaluating the plan itself.
Applying outcomes thinking allows us to shift the focus from ‘what do we do?’ to ‘what outcomes do we want to see’? The Outcomes framework has a whole of life approach and focuses on measuring outcomes related to the priorities of the Plan. It was critical to both monitor inequalities over time and have the capacity to reflect the collective effort of stakeholders to inform, providing opportunity to adjust interventions and approaches more rapidly.
In breaking down the Outcomes framework, there are 5 domains, 12 outcomes, 28 indicators, 17 targets, 78 measures and 118 detailed measures. You can access the full framework here. The Outcomes framework includes a cross-referenced table that indicates which measures can be used for particular cohorts, which I recommend you check out; and a detailed data dictionary.
In addition, the Department of Health and Human Services has developed an outcomes framework supported by the Department of Premier and Cabinet who are leading outcomes thinking across government.
Gordon’s experiences reporting on hours spent on client related work, with no clear way to measure the change in people’s lives, led cohealth to implement outcomes measurement across a range of areas for refugees and asylum seekers.
The first step cohealth took was to develop a theory of change that focussed on what they were trying to achieve against short, medium and long term outcomes. Clearly identifying and prioritizing these outcomes “provided a clarity for the team that generated a true cohesion around what is attempting to be achieved”. Importantly, three members of the refugee community were involved in creating the theory of change.
To manage the complexity of supports provided, cohealth themed activities, such as ‘capacity building’, ‘service improvement’, ‘care coordination’, ‘community engagement’, ‘person centered therapeutic care’ and ‘health literacy (knowledge of health system)’.
Two success factors included standardising terminology around timeframes (short term, medium and long term) across the service delivery and creating a plan that clearly articulated how the outcomes framework would be measured.
Some interesting questions from attendees included;
What is the role of SROI and outcomes of these?
SROIs are typically program specific – so an ongoing issue is attribution: how do we work effectively with customers, how do we adequately fund this?
What advice would you give to get executives, directors on board with investment in outcomes measurement, given that there is an emergence of reduction in administrative funding?
In the case of cohealth, funders have been quite clear in their guidance about the role of evaluation in service provision, so it was clear what direction the organisation should pursue. My own experience is that organisations who continue to delay measurement initiatives are missing an opportunity to tell a story about what they achieve.
How much authority do those outcomes have?
Indicators help a provider understand what is going on, but outcomes thinking isn’t a set of rules, it’s an iterative process. The measures show us if we are making change, and how we can link this to a narrative.
In closing, some interesting questions to consider as a sector are;
How do we contribute to progress measures as a community to harness collective impact?
How do we make sure data informs processes? What feedback loops prompt continual improvement of our theories of change?
How do we connect outcomes measurement to a bigger story- state, national or greater?
How can we share learnings more effectively across sectors? Vikki shared and example that saw a justice department now funding housing due to the clear link in housing as a critical predecessor to improved recidivism, made possible through outcomes measurement.
Thanks again to the brilliant volunteers at SIMNA who make these events possible, event facilitator Jen Riley from Navigating Outcomes and SIMNA Director Russ Wood for attending.
Finally, a huge thanks to Vikki and Gordon for generously sharing their knowledge and experiences and for all attendees who are demonstrating the thriving impact community in Melbourne.
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Written by Marli White