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What Does it Take to Actually Achieve Outcomes?

Posted on November 15, 2011

Abe Wandersman (bio) discusses Getting to Outcomes, a 10-step approach to achieving results-based accountability.


A lot of the work that we're doing now grew out of work in the 1990s, where we were working with community coalitions for substance abuse prevention. Community coalitions have now been used for many, many problem areas. But back in the early 90s was when they were just starting to get to be a way of mobilizing communities around a problem.

And what we found was that there was a lot of energy in pulling people together from different parts of the community and developing a community plan. And that would take about 18 months or so. And then when you look at the actual implementation of that plan, it was fairly scattered, not necessarily on things that were likely to work, and when it came time at the end of five years to look for outcomes, the outcomes were extremely modest.

And so we asked ourselves the question of, "What would it take to actually get outcomes?" and devised a way of thinking about it of saying, people need to be on the right track with what they do. They need to do the right thing, and they need to do the right thing well. And so we developed a ten-step approach to accountability called "Getting to Outcomes," which tries to do that.

The steps start off with what are the needs and resources in this community? What are the priority things to work on? Given that, what do you want to accomplish? What are your goals and outcomes? And then, how are you going to get there, which is a combination of using best practices, looking for appropriate fit, and having the capacity to do that program or intervention.

And then it moves into the plan. Who's going to do what, when, where, and how? And then it moves into you may have this great plan on paper, what actually happens? What's the quality of implementation? And then it moves into after you do all that work, do you actually get the outcomes? And then moves into continuous quality improvement and sustainability.

So out of that grew a very important interest in implementation and what does it take to go from a plan on paper to something that actually works.

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Excerpted from interview with Dr. Wandersman at the 2011 Global Implementation Conference in Washington, DC.


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