Cindy Olney and I just returned from the American Evaluation Association Summer Institute in Atlanta, GA. The blog posts for the next couple of months will be filled with lessons learned from the Institute. I am going to start with Outputs, because they were the greatest surprise to me.
In his “Introduction to Program Evaluation,” Thomas Chapel, Chief Evaluation Officer for the Centers for Disease Control and Prevention, said that he thought outputs were just as important as outcomes. This was quite shocking to me, since it always seemed like outputs were just the way of counting what had been done, and not nearly as interesting as finding out if the desired outcome had happened.
Outputs are the tangible products of the activities that take place in a project. For example, let’s say the project’s goal is to reduce the number of children with Elevated Blood Lead Levels (EBLL) by screening children to identify the ones with EBLL and then referring them to health professionals for medical management. In this brief project description, the activities would be to:
1) Screen children to identify the ones with EBLL
2) Refer them to health professionals for medical management
If outputs are the tangible products of the activities, they are sometimes thought to be something countable, like “the number of children screened for EBLL” and “the number of referrals.” This is how the project manager can ensure that the activities took place that were planned.
However, if you think about the way an activity can take place, you can see that some methods of completing the activities might lead to a successful outcomes, and some might not. A better way of thinking of the outputs might be “what would an output look like that would lead to the outcome that we are looking for?” To use “referrals” as an example, let’s say that during the program 100% of the children identified with EBLL were referred to health professionals, but only 30% of them actually followed up and went to a health professional. If the only information you gathered was the number of referrals, you cannot tell why the success rate was so low. Some of the things that could go wrong in a referral is that people are referred to physicians who are not taking more patients, or to physicians who don’t speak the same language as the parents of the child. So you might want to define the referral output as including those factors. The new output measure could be “the number of referrals to ‘qualified’ physicians,” in which ‘qualified’ is defined by the attributes you need to see in the physicians, such as physicians who are taking new patients, or physicians who speak the same language as the family.
The lesson for me is that outputs are as important as outcomes because by thinking carefully about outputs at the beginning of the planning process, you can ensure that the project has the greatest chance of successful outcomes, and by using outputs during process evaluation, you can make any needed corrections in the process as it is happening to ensure the greatest success of the project.