The U.S. Department of Health and Human Services (DHHS) has embarked on a process to establish performance measures for all of its health and human service programs. Performance measurement is needed as a management tool to clarify goals, document the contribution toward achieving those goals, and document the benefits received from the investment in each program.
The Office of the Assistant Secretary for Planning and Evaluation (OASPE), State and Local Initiatives Division, is working with several agencies within the Department to help them develop performance measurement approaches which embrace the following core principles:
The Divisions consultation with DHHS agencies involves activities such as: 1) helping to structure stakeholder consultation processes; 2) identifying state and local performance measurement efforts relevant to a particular agency or program; 3) evaluating the usefulness of existing national data systems for a particular programs objectives; and 4) providing feedback on proposed measures.
While performance measurement is a relatively new approach for the
federal government, several State and local governments embraced performance
measurement years ago and may have valuable lessons to share.
Performance Measurement Reports
To assist the Department in its efforts to develop reliable performance measures and assist state and local governments in their efforts to develop outcome-oriented approaches, the Department has sponsored a series of documents. First, the Office of the Assistant Secretary for Planning and Evaluation recently commissioned the National Academy of Sciences (NAS) to establish an independent panel to assess the utility of existing data systems. The resulting report, Assessment of Performance Measures for Public Health, Substance Abuse, and Mental Health, focuses on measures that state and federal governments may use over the next 3 to 5 years to negotiate agreements and monitor performance in public health, substance abuse, and mental health. The NAS panel used four guidelines for assessing the measures: (1) the measure should be specific and result oriented; (2) the measure should be meaningful and understandable; (3) data should be adequate to support the measure; (4) the measure should be valid, reliable, and responsive. The measures that scored the highest were recommended for use in performance monitoring. They cover health, social functioning, consumer satisfaction and risk status. The NAS is now completing a follow-up report to make recommendations on the development of new data systems. This report is expected to be available by the end of 1998.
The Department, in partnership with the Robert Wood Johnson Foundation, also asked the Institute of Medicine (IOM) to undertake a two-year study to examine the use of performance monitoring and develop sets of indicators that communities could use to promote the achievement of public health goals. The IOM report, Improving Health in the Community -- A Role for Performance Monitoring, draws on lessons from a variety of current activities to outline the elements of a community health improvement process, discuss the role that performance monitoring can play in this process, and propose tools to help communities develop performance indicators.
Lastly, the Office of the Assistant Secretary for Planning and Evaluation asked the Office of the Inspector General (OIG) to identify and examine State initiatives that use outcome measures to assess the performance of their public health programs. In September, 1997, the OIG produced a two-volume report, Results-Based Systems for Public Health Programs. Volume 1: Lessons from State Initiatives (OEI-05-96-00260) outlines challenges for both state and federal officials. Volume 2: State Case Studies (OEI-05-96-00261) provides brief descriptions of selected initiatives in 11 states. The two key benefits seen from implementation of the initiatives were obtaining information more efficiently and empirically demonstrating program results. The report can be obtained from the Chicago OIG office at (312) 353-4124.
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Last updated 06/222/98