Results Based Management

Original Editor - Kim Jackson

Top Contributors - Kim Jackson  

Introduction

Results-based management (RBM)is a tool, often used in business, that uses feedback loops to monitor and evaluate the outcomes and impact of strategies and projects. The aim is to introduce a structured approached that focuses on the expected results rather than the implementation and budgets. It is a strategy adopted from the private sector, where it was used to track financial results. The aim is to introduce a structured approached that focuses on the expected results rather than the implementation and budgets. Measuring results helps teams to understand the importance and value of their work.

INSERT ICRC Video on RBM

In healthcare this can be an invaluable tool when assessing the implementation of standards and procedures. It provides a structured framework for monitoring the expected results at each step of the project, the steps needed to be taken to achieve them and also evaluates the impact on the service and target audience

Although it is a strategy adopted from the private sector it is important to understand there are differences between the private sector and the healthcare sector. In healthcare humanitarian/social interventions are designed to benefit people and the quality of the outcomes depend on the quality of of the organisation. The organisation responsible for implementing the interventions have an ethical responsibility and need to consider local capacities, culture and vulnerabilities and ensure that the outcomes and benefits reflect the needs of the population. Unlike in the private sector, where people have choices to choose between, providers, goods and services, in the humanitarian sector, people are not usually in a position to choose the aid they receive or where it comes from. This why strategies like RBM can promote ethical responsibility, by ensuring the focus is on performance and results. RBM can be adopted when looking at:

• Project Cycle Management
• Rehab Cycle Management

The Results Chain

The results chain explains an intervention in terms of inputs and activities where the results can be categorised as outputs, outcomes and impacts. The results of an intervention be described as:

• Intended or unintended
• Positive or negative

RBM will have different implications and meaning depending on the level of operation. Coordinators will focus more on outcomes whereas those who have a more hands on approach and work in the field will focus more on outputs.

Outputs

Outputs are the results of an intervention, for example products, capital goods or services. Outputs are the first results seen from an intervention or activity.

Outcomes

Outcomes are the predicted or achieved medium-term effects of an intervention's outputs. There is less control over an outcome than an output but outcomes are a significant factor in the chain as they represent the real changes that are expected from any given intervention.

Impacts

Impacts are the reason, and justification, why an intervention was identified. The impact of all the efforts of the previous steps represents the effectiveness of the desired goal. The end results may not always reflect the expected goal and can be viewed as positive or negative, direct or indirect, intended or unintended.

Project Cycle Management Planning for Results

Project Cycle Management (PCM) describes the process of planning and managing projects. Setting clear goals and objectives will help to plan for better results. The project cycle helps to guide the RBM by outlining the steps that lead to successful outcomes.

The ICRC describes planning for results as "A corporate function that assesses context, target groups, problems/needs, risks, constraints and opportunities and sets priorities to ensure an appropriate level of coordination and alignment of actions and resources towards the achievement of expected results"

The aim of PCM is to maximise the benefits of projects for the intended population and ensure that projects:

• are relevant and will meet the needs of the intended population
• that objectives can be realistically achieved and take into account the environment and available personnel and resources
• are sustainable

The Process

The first step of RBM in healthcare is important to set objectives that focus on the population and their current situation and the intended outcome of any intervention. The objectives need to be written with the desired outcome in mind so that that the results can be measured and assessed to ensure that there has been a positive impact on the targeted population []. Once the objectives have been set and been agreed the following phases are necessary to ensure that the project is successful and meets the identified goals and desired outcome:

• Assess -What is the current situation? Identify problems!
• Think - What caused it? Who is involved? What are we going to achieve?

• Plan/design - What is the desired outcome? Set objectives, strategies and activities that are needed!
• Implementation - This is the stage where activities are undertaken
• Monitoring - This is important throughout the whole project so that any successes and/or changes are identified to meet the set goals
• Review and Evaluation - This can be carried out at any stage highlighting any recommendations and adaptations.

Obstacles and Barriers to RBM

Whilst RBM has been identified as necessary in planning interventions and guiding their success and benefits in developed and low middle income countries (LMIC) There can be many barriers, including political, organisational, technical and availability of manpower and trained staff. It can also be difficult to predict results the social impact of initiatives in the short term and the results can often take years, rather than months to see the healthcare improvements and benefits to the healthcare users.

Resources

• Programme/Project Management: The Results Based Approach