Tuesday, August 13, 2013

MEASURE WHAT MOTIVATES US

ADALSTEINN BROWN ILLUSTRATES THE RELATIONSHIP BETWEEN WHAT WE MEASURE AND WHY WERE MOTIVATED, REVEALING AN INCREASINGLY COMMON FAIL POINT IN OUTCOMES-FOCUSED PUBLIC BENEFIT WORK

O
ADALSTEINN D. BROWN Director, Institute of Health Policy, Management, and Evaluation and Dalla Lana Chair and Division Head, Public Health Policy, Dalla Lana School of Public Health University of Toronto

ne of the most positive things about working in the public good sector is the motivation of the people around you. The people working in charities, foundations, the health sector, and the social services sectors find the work rewarding. This motivation that doing good is worth doing is the reason why the backgrounds of people in the public good sector are so varied. Look at any organization and you will find academics, former business people, and many who have dedicated their entire professional life to a particular cause or organization. I had a long talk with a friend last week who spent the first part of his very successful career working in the epitome of the for-profit private sector. He has spent the last few years working in the public good sector and despite repeated lucrative offers to re-join the private sector he has decided to commit the rest of his career to the public good sector because it is more rewarding. Over the past several years, however, there has been a movement in the public good sector towards a greater focus on outcomes. Although we have always measured what we are doing in the public good sector, we have often looked at how many people we have supported, how much money we have raised, or how many people know and support our work. This new focus looks instead at how much we have helped people. For example, how many people have moved out of poverty, how many people have stayed in school, how safe are communities or how many people can live at home in safety and with dignity. This new focus has found many forms including social investing and impact philanthropy. At times, these new forms seem to run contrary to the goals of the public good sector. But the focus on outcomes is a critical one if we are to continue to improve our performance. In this era of global economic crisis, it will be critical to show continually improving performance at every opportunity to justify the resources we receive and to compete for more. As the business pundits say, you cannot manage what you cannot measure. The link between management and measurement is well-documented, but so are the risks that come with a myopic view of measurement as the singular or primary tool of management. My colleague Gwyn Bevan from LSE introduced me to the concept of synecdoche or as he eloquently phrased it hitting the target but missing the point. A focus on measuring easy-to-measure things like the number of people served or wait times can lead to a host of inappropriate behaviours including fraud. But it can also be more damaging because this sort of focus separates people from their fundamental motivation for coming to work. Most people in the public good sector come to work every day because they want to see a change in the world not because they want to process more paperwork, visit more clients, or treat more patients. They come to work because they want to see a more just society, ensure more people can live in dignity, or to help people stay healthy and cope with disease. This difference between what we measure and what motivates us may seem like a challenge to the current focus on measurement. It is not. We should continue to measure what we are doing but we should also within the limits of reasonable expenditure try to get the best possible measures. My test for what makes a good measure is how tightly it is linked to the ultimate goal of the organization. The more tight the link, the easier it is to motivate the people with whom I work and to build meaningful and sustainable partnerships with others. A year ago, I wrote a paper with my colleagues Ross Baker, Tom Closson, and Terry Sullivan where we argued that the table stakes for successful transformation of healthcare were a clear plan with goals, meaningful measurement against these goals, and the engagement of people working in the system on improvement against these goals. All of this may sound like simple management speak, but it is a critical management perspective if we are to maintain the motivations of people working in our system. Any perspective that stresses rewards and tests without this link to our underlying motivations for our work will fail.

THE DIFFERENCE BETWEEN WHAT WE MEASURE AND WHAT MOTIVATES US MAY SEEM LIKE A CHALLENGE IT IS NOT.

Sourcing bright ideas, fresh perspec tives and personal opinions on transformational change from Ontario and around the world

www.otf.ca/sic