Keep Rowing! Setting and Achieving Measurable Outcomes in the Ever-Changing “Ocean” of Children’s Residential Services

Developing and operationalizing meaningful short- and long-term outcomes for residential programming can feel overwhelming when so much time and energy needs to be dedicated to providing day-to-day services and meeting safety and regulatory requirements. However, outcomes are essential for understanding and communicating effectiveness and impacts (Sisson, 2007), engaging in continuous improvement and motivating staff. In this presentation, Nexus Family Healing will share a practical, multi-year, incremental plan for building out short- and long-term outcome measures that can meet these key needs while aligning with existing structures such as grant requirements, accreditation expectations and the desires of multiple stakeholders, including clients and families. This “living” plan allows for the gradual development of robust measures that can be utilized by non-clinical areas of the organization (such as marketing and communications) as the work of developing outcomes gradually moves forward and becomes comprehensive. In addition, to increase ease of use and relevance to funders, measures under development are aligned to Social Determinants of Health. Modeling program activities and performance can also incorporate day-to-day quality activities so that quality improvement staff can utilize models as guides for their work.

Attendees will receive a walk-through of the basic components of logic models, the importance of assuring model fidelity for evidence-based practices and as a foundation for outcomes, and the linkages between short-term (measurable) outcomes and existing literature to structure long-term outcomes that are reasonable and easy to understand. This approach can be replicated at any agency using the templates that will be provided in this session as well as tips for engaging staff in the development of measures, honoring practice wisdom (aka, “practice-based-evidence”), and practical ways to access research literature in this age of library and journal paywalls.

Importantly, this plan is itself a dynamic strategic structure and the status of measurement development and the real-life experience of implementation in a large, complex organization that – like others – is adopting and standardizing an electronic health record system and dealing with high staff turnover. Implementation experiences will be shared so that attendees understand some of the actual challenges and pitfalls and ways to address them while still maintaining momentum.


Anita Larson, DPA

Director of Quality & Outcomes , Nexus Family Healing