Transcript Introduction to Outcomes Based Service Delivery in

Introduction to
Outcomes Based
Service Delivery in
Southern Alberta
David O’Brien MSW, RSW
Southern
Alberta Child
and Family
Services
Authority
What is Outcomes Based
Service Delivery?
• Outcomes Based Service Delivery (OBSD) is
an approach to managing the expenditure of
public funds to achieve social policy goals.
• It involves program management through
measurement of outcomes achieved by
clients.
• Isn’t this the way things have always been
done?
2
Traditional Social Policy and
Program Development
• To address social problems governments
pass laws, creating a legal authority for a
service delivery program.
• Government employees design and deliver
services to mitigate the problem.
• Government is often both purchaser and
provider of the service (schools, hospitals).
• In Children’s Services most intervention
services have been purchased from
community agencies.
3
Performance Measurement:
Inputs Versus Outcomes
• Outcomes for ‘soft’ services such as child
safety are believed to be difficult to measure.
• Performance measures are often based on
inputs (cost per unit of service), rather than
outcomes (observable benefit to a child).
• This puts the focus on efficient management
of resources, rather than outcomes.
• Example: a parenting group class is offered
because it is less costly than providing in
home supports for the same families, but how
do we know which makes children safer?
4
OBSD is About Ends
Rather than Means
• Outcomes measurement is based upon a
concrete, behavioral description of client
capabilities post intervention.
• Not on the number of sessions attended,
hours of service delivered, satisfaction
surveys, or client self reports.
• Outcomes need to be observable to be
measureable.
• OBSD is about achieving clearly defined
ends (child safety), rather than facilitating
the means to an end (providing services).
5
Mandate for Change
• Alberta Response Model (2001)
• Child, Youth and Family Enhancement Act
(2004)
• Casework Practice Model (2007)
All called for:
• Increased client engagement
• Shift towards prevention and early
intervention from core protection
• Closer integration of Children’s Services into
the community of family support agencies.
6
OBSD Calls for Change in
Authority-Agency Relationships
• In traditional child protection work the
authority completed its assessment of needs
and intervention plan before contracting for
services from community agencies.
• There was a hierarchy of workers and
processes; the ‘deciding’ work was separated
from the ‘doing’ work.
• This medical model based approach sees
diagnosis as the highest skill. The ‘expert’
making the diagnosis is seen as best equipped
to prescribe the treatment.
• OBSD calls for authority/agency partnership.
7
OBSD Calls for Principle-Based,
Collaborative Practice
OBSD was built from the principle:
“Authority, agency and family will work
collaboratively to identify needs, develop
a single plan, and achieve agreed upon
outcomes.”
OBSD practice calls for joint authorship
in the intervention process.
8
Collaboration is More than
Co-operation
• But haven’t we always collaborated?
• CS has always co-operated with agency
partners in the sense of coordinating our
parallel processes; for example, an agency
plan to complement the authority intervention
plan.
• This is not the same thing as the authority
and agency worker producing a joint plan
through a shared process with the family.
9
OBSD: Interdependence
versus Integration
• In OBSD the authority and agency workers do
not become one. The authority worker alone
retains delegated child protection authority
and accountability.
• What we are working to accomplish: safety,
security and healthy development for children
is rooted in legislation and is not negotiable.
• Choices about how we accomplish safety (or
who does what) are shared by the authority,
agency and family working together.
10
Developing a Joint OBSD
Process
• OBSD was founded on the belief that
expertise for practice is embedded in the
hard won knowledge, skills and abilities of
front line staff of both the authority and
agency in facilitating communication and
intervention processes with families that
build safety and wellbeing for children.
• This is the expertise used to develop the joint
OBSD practice process.
• Developing the OBSD model was worker led.
11
Building OBSD Process in
Partnership with Families
• OBSD process is a relationship based
approach, rather than an expert model.
• Or working with, rather than working on people.
• Workers approach the family with an ‘attitude
of not knowing’ and engages in a joint process
of discovering what is and what might be,
rather than what is not and what should be.
• The OBSD process was developed by workers
through reflection on what could be seen to
work with families.
12
OBSD and Signs of Safety
• OBSD can be done without use of the
Signs of Safety and the Signs of Safety
can be done without OBSD, however. . .
• In the Southwest Region the OBSD
Pilot involved transitioning to Signs of
Safety based practice as both are
based upon the same principles of
inclusive, collaborative, strengthsbased, solution-focused, relationshipbased practice.
13
Outcomes Based Learning
• Focusing on outcomes teaches us what
works best with the families that we serve.
• Developing collaborative relationships with
individual families teaches us what success
looks like to them as well as to us.
• Strengths based solutions are specific to the
family, requiring the service provider to
custom build a family centered intervention
through the development of an extended
family and community based support network
for the child.
14
Norming OBSD Thinking
• The experience of working in an OBSD model
is demonstrating the real possibilities of
partnerships in child protection; we produce
better outcomes by working together.
• In OBSD practice agency and authority
workers share joint accountability for their
process with the family and the outcome; it’s
not a case of mine plus yours, but ours.
• OBSD sees (extended) families and
communities as full of resources, by
including everyone with an interest in the
child we build safety.
15
Interdependent
Partnerships
is Becoming the New
Norm in Child Protection
We look to the community to
help us to complete this shift in
practice.
16