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The purpose of this chapter is to identify ways to design and develop programs that are both effective and responsive to client needs. Two different perspectives, when combined, provide managers with a conceptual framework for formulating program design: (1) The logic planning model is designed to plan for, achieve, and demonstrate program effectiveness with clients; (2) the marketing planning model provides a framework for responding to service consumers’ wants and needs.

DESIGNING A LOGIC PLANNING MODEL

Using Social Systems Analysis

In a logic planning model, a human service organization’s various service delivery elements are related to each other to produce intended results. Social systems analysis is a useful analytical framework for understanding how various parts within organizations interact effectively. This planning model shows the logical relationship between the objectives to be achieved and the resources and activities that are involved in achieving them. Human service organizations can best be understood by breaking them into elements related to inputs, throughputs, outputs, and outcomes.1

Inputs are of two kinds: client inputs are people who need services to improve their conditions and achieve their objectives; resource inputs represent the elements (e.g., staff, funding, facilities, and equipment) in the human service system that combine to help clients change themselves from persons with problems and needs into persons whose problems have been resolved.

Throughputs (usually referred to as “activities”) are those interventions or processes that the agency provides for clients. The number of service units or interventions that clients actually receive (e.g., counseling interviews or educational sessions) is referred to as outputs. The positive change that occurs as a result of the intervention is the outcome. In human service organizations, throughputs might include counseling, job training, day care, information referral, and housing services. To accomplish throughput, organizations identify and implement a variety of activities to enable clients to accomplish their objectives. These could include, for example, assessing clients, conducting transactions between staff and clients, negotiating with internal and external service providers, providing direct services, and altering the client or the environment in some significant way.2

To more clearly show the range of activities available during this throughput process, it is useful to design a client flowchart that tracks clients from beginning to end. The term pathway is sometimes used to describe this sequence of structured contacts with clients as they move through the service delivery system. Pathways can be either a single route or multiple routes. Different clients in the same organization might follow different pathways, and, of course, different organizations vary in the way clients move through their systems.

The value of a client flowchart is that it depicts various pathways clients can take into, through, and out of an agency. It identifies various points along the process where crucial decisions have to be made, where activities need to be monitored for feedback, and where different alternatives might need to be considered. Symbols used to describe client pathways are shown in Figure 3.1.

•  An arrow connects another process, question, or ending symbol.

•  Dotted arrows reflect returning to a previous step.

•  Three methods for closing a case are

1.  the agency could make a referral to another agency,

2.  the client could voluntarily discontinue because the problem is solved, or

3.  the agency could terminate the client.

Figure 3.1   Client Pathway Symbols

Review of a Generic Client Flowchart Model

Figure 3.2, a generic client flowchart, depicts a client moving through an agency that provides mental health counseling and that can also arrange for such outside services as housing, employment, or day care. Note that the client can be referred to the agency from several sources, such as self-referral, a family member, or the local school. During intake, staff determine whether the client is eligible for the service and meets appropriate requirements (e.g., income level, geographic location, and motivation for service). If the client is ineligible, the agency ends the contact with the client and, if appropriate, makes a referral elsewhere.

If the client continues, an intervention plan involving the achievement of specific objectives is mutually agreed upon between the agency and the client. Subsequently, the agency provides the agreed upon service(s). If the objectives are achieved, then the agency terminates the client as a successful case. During this process, the agency works to identify and remove barriers, either within the client or in the environment, that impede se

This generic flow chart reveals several instances of clients being at yes/no decision points that may involve their leaving the agency, returning to a previous process, or being referred to an outside agency. Client pathways should make these decision points clear, because they focus attention on those instances where clients’ needs may require new or different ways of delivering services. In developing client pathways, be especially mindful of possible dropout points.

If Agency A determines that the client would benefit from Agency B’s services, then a referral would be made, and Agency A may (or may not) monitor the delivery of services and the achievement of objectives. If barriers were encountered in Agency B, Agency A could pursue alternate referrals—or this could be the responsibility of Agency B. In examining client pathways through a particular service system or agency, consider the following questions:3

•  Can there be multiple entry points?

•  Is there only one pathway, or are there multiple pathways through the system?

•  After going through intake, if the client is referred to a specialist, must the client return to a central point before going on to a second specialist, or can the first specialist make a direct referral?

•  Can a client go directly to a specialist, thus bypassing a central intake?

•  How permeable are the agency’s boundaries to admitting people (e.g., eligibility requirements, waiting lists, and bureaucratic “red tape”)?

•  What alternative pathways are open to clients if their conditions change or their objectives are not met?

•  If certain objectives are met, but others are not, what does the agency do?

•  Can clients who prematurely discontinue be recycled back into the agency’s program at a later point?

•  Does the agency attempt to re-engage and critically examine the reasons why clients drop out?

•  Are those clients who need to be referred to outside agencies being assisted, and do staff follow up to determine whether the services were, in fact, provided and objectives achieved?

•  Have proper forms (intake, screening and assessment, eligibility, admissions, case planning, evaluation, and termination) been developed to engage and track client progress through the service system?

The value of these questions is that they provide an analytic framework for viewing how clients are being treated as they are processed through the service delivery system.

Outputs are the direct products of program activities and usually measure volume of work accomplished.4 The focus of an output performance measure is on the service. There are three types of output (units of service) performance measures:5 (1) a material unit, such as one home-delivered meal; (2) an episode unit, such as one interview; and (3) a time unit, such as one hour for a home health aid program. An agency aggregates these performance measures across all clients receiving services, producing monthly or annual reports. The following are examples of output performance measurements:

•  Number of counseling sessions

•  Number of educational materials distributed

•  Number of meals provided

•  Number of community meetings held

•  Number of clients completing a program

•  Number of seniors completing prescribed, short-term treatment plans

•  Number of children completing preschool education

In these examples, output units are shown as both units of service provided and units of service completed. Although most organizations are able to document their service units, by themselves these units are an insufficient measure of accomplishments. For that, outcome measures must be considered.

Outcome measures are defined as a measurable change in a client’s life achieved between entry and exit of a program. The resulting accomplishments are attributable, at least partially, to a human service program.6 In the absence of formal research, we can never be completely certain that the outcomes are the result of agency intervention. The fact that students are functioning at a higher grade level, or that people are able to get jobs, or recidivism rates are reduced may or may not be due to program interventions. Nevertheless, agencies can claim that client outcomes are at least partially attributable to the service interventions. The following are examples of outcome measures:7

1.  Service data:

•  Job placements

•  Reduction in number of clients with arrests 90 days after completing treatment

•  Decline in child abuse

•  Performance at or above grade level

•  Discontinuance of drug use

•  Adults completing treatment reporting they are abstinent

•  Participants who receive a General Education Diploma (GED)

•  Participants retained in employment after one year

•  Homeless persons obtaining housing

•  Reduction in confirmed cases of abuse or neglect

•  Children placed with adoptive families within 180 days of the receipt of referral

2.  Standards for measuring outcomes:

•  Preschool behavior rating scale

•  Parent attitude survey

•  Knowledge scales and aptitude tests

•  Note: These scales document how people have changed after they have been involved in an intervention process.

3.  Level of functioning scales that measure outcomes:

•  Rating of mentally ill on decision making and interpersonal interaction

•  Rating mentally disabled on daily living and communication

4.  Client self-reported satisfaction as a measure of outcomes:

•  Satisfaction among clients who were treated or who were provided with services

•  In day care, percentage of parents reporting their placement is safe, healthy, and nurturing

•  In a homemaker services program, consumers who feel that they have improved their functioning

•  In a nutrition program, consumers who feel that the meals program is an important source of nutritious meals

•  Note: Although client satisfaction can be useful, human service managers need to be cautious about overusing this scale as a substitute for more objective scales of outcomes.8

Establishing Initial, Intermediate, and Long-Term Outcomes

For most clients, there is usually not one desired outcome, but rather a hierarchy of logically related benefits to be obtained from a program. This hierarchy is generally related to the length of time over which benefits can occur. Initial outcomes are the first benefits clients experience and are the ones most closely related to a program’s outputs. These initial outcomes are immediate changes in participants’ knowledge, attitudes, or skills, and they are necessary steps toward ultimate desired ends. In a school dropout prevention program, for example, an initial outcome would be students’ active participation in a tutoring program and greater participation in school activities. In a job training program, an initial outcome would be learning a word processing skill or developing a better attitude about supervisors. Initial outcomes measure changes in program participants while they are still in the program.

Intermediate outcomes link the program’s initial outcomes to long-term change in behavior that results from participants’ new knowledge, attitudes, or skills. In a job training program, an intermediate outcome would be placement on a job. In a school dropout program, an intermediate objective would be regular attendance in school and passing to the next grade level. Intermediate objectives reflect participants’ accomplishments at the end of the program or shortly thereafter (e.g., within three months of terminating the program).

Long-term outcomes are those changes in the client’s quality of life (such as improved parenting or job stabilization) that are measured at a designated follow-up time.9 These measurements can occur six months, one year, or even two years or more after the completion of the program to determine whether the initial gains were sustained. It would measure, for example, whether the person continued to be employed 12 months after completing training.

The reason to make this distinction is to acknowledge that achievements clients make at the end of the program may or may not be meaningfully sustained. Welfare recipients may be placed on jobs at the end of a training program, but they may not be employed 12 months later. Similarly, adolescents participating in a teen pregnancy prevention program may have increased their knowledge about using contraceptives, but their behavior may or may not have changed and they may become pregnant six months after they leave the program. Thus, the definition of success will vary depending on whether the focus is on initial, intermediate, or long-term outcomes.

In addition to considering the timeframe in determining outcomes, managers must also demonstrate the logical relationship between cause and effect, that is, how program interventions logically impact intended program results. This relationship can be thought of as an “If A, then B” chain of influences and benefits.10 Consider the following:

If the program can provide job training skills (throughput) for welfare recipients (input), and if clients complete the 12-week training program (output), then they will be able to have more effective job interviews (initial outcome). If they have better job interviews, then they are more likely to find jobs that match their abilities and interests (intermediate outcome). And if they find suitable jobs, then they are more likely to become financially self-sufficient (long-term outcome).

By articulating these “if-then” statements, you make clear the assumptions for achieving desired outcomes. Subsequently, if that desired outcome is not in fact achieved, you may need to reexamine the assumptions upon which the program is based and consider making revisions. For example, if after the job interviewing training is completed people still do not obtain jobs, then you need to reexamine whether a program based on providing interviewing skills is the most appropriate means of achieving this objective.

To illustrate the relationship of inputs, throughputs (activities), outputs, and outcomes, consider how an employment training program would be designed to enable welfare recipients to obtain jobs:

Long-term outcome: Participants remain on the job 12 months after completing the program.

Intermediate outcome: Participants are successfully placed in jobs.

Initial outcome: Participants learn how to participate in a job interview; they develop skills.

Outputs: Participants regularly attend 12 weeks of intensive training.

Throughput: Program provides classes on grooming, job interviewing, and word processing.

Inputs: Department of Human Services identifies participants for the program. Agency provides instructors, manuals, and other teaching tools.

Evaluating Outcomes

The logic planning model provides a way for both managers and outside funders to evaluate the extent to which the organization achieves its intended impact. By using measurement indicators attached to objectives, it is possible to determine the effectiveness of the organization. For example, you would indicate the percentage of foster children projected to be placed in permanent families (their own or others) within one year. It is then easy to evaluate whether this was or was not achieved at the predicted, quantifiable level. Your decision about the level of expected achievement is based on your professional judgment and experience. Outcome projections are your best assessment of what will result from your intervention. For each expected outcome, you would determine how you would know that the outcome was achieved by providing quantitative indicators. This is how an agency providing transitional shelter for homeless families and children could evaluate itself in a given time period (e.g., one year).

Outcome 1: Families achieve residential stability.

Indicator 1: 90% of families pay their rent on time.

Indicator 2: 86% of families pay their utilities on time.

Outcome 2: Adults and families obtain job skills, education, and/or stable employment.

Indicator 1: 88% of adult participants are employed full time.

Indicator 2: 85% of adults are enrolled in GED classes, job training, or college.

Outcome 3: Families achieve greater self-determination.

Indicator 1: 72% of adult participants attend post-treatment care group and maintain sobriety.

Indicator 2: 90% of families complete their individual case plans.

At the end of the program period, the agency provides a report comparing the projected outcomes with actual outcomes in an evaluation review. Ideally, before the end of the program period, if there are significant discrepancies emerging between projected and actual outcomes, agency management would have been asking, “What resources are necessary to make the program more successful? Should we alter our client input? Should our interventions be modified? Should the number of units be increased or decreased? Do we need to modify our outcome measures to make them more realistic?”

In summary, the logic planning model helps managers critically examine how inputs, throughputs, outputs, and outcomes are connected. The starting point in developing a logic planning model is with the desired end state or target. You ask the question, “What do we want to accomplish?” and then work backward to figure out what needs to be done to achieve the target. This approach opens up the possibility of challenging the status quo and encourages “out of the box” thinking that could lead to more effective action planning. The kinds of questions that lead to action planning are as follows:11

•  What program elements are critical to achieving what we want to accomplish?

•  What program interventions need to be modified to achieve our objectives?

•  What new program components should be considered to meet our objectives?

•  How will we define success at initial, intermediate, and long-term intervals?

DESIGNING A MARKETING PLANNING MODEL

Determining the Consumer Service Market

As previously discussed, the logic planning model designs and measures programs based on their having an impact on service consumers. The marketing planning model provides a different perspective on developing effective service delivery programs. This approach focuses on determining what consumers of services (the market) want and then how the agency can meet those needs. A market-driven organization is one that understands its niche and works at how it can best meet the needs of its consumers.

After completing or revising its strategic plan (see Chapter 2), an organization has assessed its unique skills and competencies and can determine its niche—its place in the community for meeting an unmet need or responding to an opportunity for a new service that is within its mission. To better assess whether to modify an existing service or embark on a new one, an effective manager conducts a competition analysis to review whether other agencies are offering similar services or different services to the same clients. A neighborhood center, for example, offers recreation services to seniors and determines that seniors in nearby public housing do not make use of the center’s programs. Although the local YMCA provides services for youth in public housing, it does not offer social and recreation programs for seniors. Based on a marketing analysis, the manager concludes that a need exists and that other agencies are not meeting it. The neighborhood center proceeds to develop a recreation program for seniors in public housing.

A focus on consumers of service (also conventionally referred to as clients) is at the heart of the market-driven approach. To convey this emphasis on meeting consumer needs, some organizations equate service consumer with customer, but this is an inaccurate application of terms. In private sector transactions, customers both pay for and receive the service. Private sellers of the service strive to preserve an ongoing relationship so that the customer will continue to buy their services. The word customer also implies that people have a choice to go somewhere else if they do not feel they are getting something of value in the transaction.

In the human services field, the person or entity paying for the service is usually not the consumer of the service (except in those few instances where clients pay full fee). Because many organizations experience more demand for their service than what their resources will allow, because dissatisfied clients who leave the agency can be replaced by someone else on a waiting list, and because funding limitations force agencies to reduce services, agency staff may tend to treat their consumers with less care and consideration. The term customer is used as a metaphorical expression to convey the importance of treating people with care and dignity. One should be cautious, however, about applying too literally the language of business in designing human service programs. Asking staff, for example, to refer to their homeless clients, or adolescent delinquents, or substance abusing service consumers as “customers” could feel awkward and insincere.

Offering the Consumer Outstanding Service

Because human service consumers rarely pay the full cost of service, some organizations may not feel the same obligation to respond to their needs as if they were full-paying customers. Human service organizations, however, must emphasize the primacy of the client. This sign was hung in the administrative offices of a public housing authority:

We believe that our clients are not an interruption of our work; they are the very purpose of it. We are not doing them a favor by serving them; they are doing us a favor by giving us an opportunity to do so.

Even when a human service organization’s staff believes that their clients are their reason for being, a number of factors can inhibit this from being their core purpose. If program funding is received from a third party, consumers may not have a direct way to express their concerns because they are not paying for the service. If consumers are considered fungible—that is, if there are so many people waiting to be served that dissatisfied ones can easily be replaced by others—then there may be little or no impetus to deal with client discontent. If too great an emphasis is placed on administrative or staff convenience, then meeting the needs of consumers becomes secondary. If the delivery of services involves more than one organization or more than one unit within an organization, their competitive, territorial attitudes can result in consumer services becoming fragmented and overly burdened with bureaucratic procedures.

The antidote for these inhibitive factors is a value commitment to—even an obsession with—meeting consumer needs. Effective managers must clarify to employees that this is fundamental. Organizations must develop a good feedback system and a method for reminding staff of the primacy of consumers. One major way to obtain feedback is through periodic, formal client satisfaction surveys. Just as hotels and car repair shops ask their customers regularly for suggestions on how to improve their services, human service organizations could benefit from such formal surveys of their constituents. Some organizations use a feedback device titled “Give Us a Grade,” in which consumers are asked to answer questions or provide a rating regarding whether their expectations were met, how they were treated, and their level of satisfaction with the quality of care they received. Encouraging comment cards and letters—both positive and negative—helps staff understand how their services are perceived.

Some organizations even have management staff pretend they are consumers. They may call or visit an office where they are unrecognized to see firsthand how their concerns are handled. This is a common practice in retail stores that arrange for management, staff, or outside “professional shoppers” to experience what it is like to be treated as a customer. The purpose is not to evaluate specific individuals as much as it is to determine how responsive the system is to consumer needs. Experiencing the organization as a consumer can reveal discrepancies between how things should work and what actually takes place.

The message being promoted throughout the organization is that everyone serves clients directly or indirectly. If employees are not involved in direct service, they ought to be facilitating the work of those who are. This means that everyone in the organization has a client to serve: supervisors facilitate the work of their staff, accountants provide needed information to management, and support staff assist staff who work with clients. Consistency between rhetoric and action is vital if employees are to believe and accept that the organization sincerely cares about its consumers.

Many obvious clues indicate whether an organization is consumer friendly. Telephone calls are promptly answered. Staff parking is not any more convenient than client parking. The reception or waiting room is inviting, and the receptionist conveys a warm welcome to visitors. Intake and service staff genuinely convey positive acceptance and go the extra distance to be helpful to clients. Appointments are promptly kept; apologies are given if clients have to wait. Clients and volunteers are treated as genuine partners engaging in meaningful activities that assist the agency. They may, for example, be asked to serve on advisory committees, or on the board itself, to make suggestions to improve agency services.

These are small efforts, perhaps, but they project the organization’s fundamental emphasis on the dignity and importance of the consumer. And they do not occur by happenstance. The culture of caring permeates the entire organization as it continually reinforces this primary value in new policies, staff meetings, annual reports, training programs, and documents describing particular programs. Effective managers do not tolerate denigrating comments about clients or coworkers. Through special training and supervision, staff learn how to treat clients with respect and dignity even when having to cope with hostility and complaints. By frequently stressing its commitment to caring and proving that commitment time and again, the organization develops a reputation for being responsive to the needs of the people it serves.

Three rules can be applied to good consumer service.12 First, the consumer is not always right, but the consumer is always the consumer, and therefore it is crucial to fix the problem. Although consumers can be mistaken at times, their perspective is extremely important. Managers must infuse in their organizations an attitude of understanding and of trying to respond to consumers’ perceived needs. For example, you have designed a program to provide substance abuse counseling, but a number of your clients express concern about the lack of adequate housing. Certainly they must deal with their substance abuse, but you also need to consider ways within the agency or through referral to respond to their housing needs.

Second, consumers have crises, and it is therefore important to address their problems immediately. From the perspective of the consumer, the problems need to be addressed with a sense of urgency. Programs need to be prepared to offer a compassionate response to what consumers feel is a crisis. Some agencies use this approach by providing wrap-around services—a range of services provided on a 24-hour basis, especially for adolescents who are likely to get into difficulty at times other than regular office hours.

Third, seek total consumer satisfaction. Never assume that clients, even those who evidence strengths and competencies, can automatically connect their problems to your solutions. Asking, listening, and responding are at the heart of providing outstanding consumer service. Solving consumer problems means that you need to understand their perspectives. Incredibly good consumer service starts with having insightful empathy for clients’ problems and needs. Recognize, too, that though consumers come with their own strengths, they also are sometimes powerless and need an advocate to help them negotiate various community institutions for resources to sustain a decent quality of life.

Seeking Consumer Feedback

To understand better the special needs of their clients and also the interests of outside funders and public officials, agencies seek feedback to guide them in program development. To better understand consumer needs, organizations conduct focus group sessions, ask for consumer reactions through formal and informal surveys, and elicit client complaints.

Conducting focus groups is a useful way to generate ideas about consumer needs and reactions to programs.13 It is often a good idea to convene focus groups of similar consumers (e.g., separate meetings for Latinos or African American consumers, or of teenagers and adults) because their perspectives may be influenced by cultural and other unique characteristics. Usually a focus group consists of eight to ten consumers and is guided by a facilitator who asks such open-ended questions as, “What appeals to you about the program? What aspects of the program turn you off? Who do you think would benefit from the program? How often should the program be offered? What would persuade you to try this program?” Responses to these questions can provide helpful directions for future programs.

Frequently, agencies survey current consumers about how they benefited from the service and what changes they would recommend. In conducting the survey, keep questions brief and focused, and be clear about what the specific value will be of each question. Surveys take time, financial commitment, and a degree of expertise. Have qualified researchers review questionnaires so as to avoid bias and potential distortion of results.14 Consumers would rank services on the basis of accessibility, appropriateness of service, acceptability, recommendation of further service, and overall satisfaction.

A more open-ended approach is to use the Internet so that people can describe what they like if they are current consumers or what services they would like if they were to use your program in the future. Provide an easily accessible part of the website for people to request more information or for making suggestions about your services. Also, make sure that someone responds on a daily basis. A word of caution: do not over-rely on the Internet to obtain feedback on your services. Not all of your consumers can access the Internet, and be mindful that overusing Internet surveys can be perceived as pestering.

Everyone in the organization can be involved in a marketing effort to ascertain how consumers feel about their services and about the agency. The receptionist and intake worker can ask consumers how they learned about the organization. Board members and volunteers can ask people what they have heard about the organization. Feedback then needs to be channeled to staff who can respond. For example, if someone complains about the facility’s physical appearance, that information has to be passed on to the maintenance staff. Continuous soliciting of opinions about the kind, quality, and level of service your organization provides shows that your staff care.15

To convey to consumers that they have basic rights, many human service agencies publicly post these rights at the agency or include them in intake handouts given to consumers. For example, consumers are informed that they have the right to obtain courteous and fair treatment and be treated with dignity. They are told that the information they give is confidential. Any state laws that limit confidentiality are explained. They also have an opportunity to communicate their concerns and obtain resolution of them. Some organizations create consumer relations teams whose job is to answer questions, resolve problems, and ensure that all clients receive prompt, courteous, and professional service. Clients have access to a conciliation procedure that invites them first to talk with the staff, then a supervisor, and then a customer relations specialist (also known as an ombudsman or a client advocate) who can meet with staff and clients in a conciliation process before they are carried to other county or state hearing levels. Consumers know that they can file an appeal without fear of repercussions, including interference, coercion, or loss of services.

Based on the feedback from its present and potential consumers, organizational managers are better prepared to consider both the services your agency could offer and your possible target markets.16 Four fundamental questions could be explored:

1.  How can we expand our existing services to our current customers? Example: A job training program contracts with the county commissioners to expand job training services to clients who live outside the central city.

2.  How can we develop new services for current consumer segments? Example: Your program is designed to provide counseling and support for high-risk students who are in danger of dropping out of school. The teenagers seem resistant to talking directly about their problems, so you design a program where they can work on creative art projects while permitting informal discussions of issues that concern them.

3.  How can we find new consumer segments for current services? Example: A neighborhood mental health counseling center contracts to develop a residential facility to house mentally ill women for whom they can provide ongoing counseling.

4.  How can we develop new consumers and new service programs? Example: A family service agency contracts to develop a substance abuse prevention program in the elementary schools.

Being Responsive to External Markets

Effective managers rely on market planning as they consider the role of stakeholders—those who have a keen interest in the organization, though they do not receive direct service benefits. Stakeholders can be trustees, volunteers, family members, fund donors, service advocates, referral sources, elected officials, and community leaders who must all be satisfied with the effectiveness and efficiency of services delivered.

Three elements comprise the external market: referral sources, policymakers and administrators, and funders. Human service organizations need all three to survive. Referral sources—such as the courts, city or county departments of human services, and nonprofit agencies—send consumers to agencies. Policymakers and administrators—such as elected and appointed officials, United Way leaders, and accreditation and credentialing professionals—control resources and enact regulations that influence how your organization functions. Funders—federated campaigns (e.g., United Way, United Black Fund), foundations, insurance companies, individual donors, and faith-based drives—provide needed resources. You need to be constantly tuned in to these external markets so you can then better serve your consumers. Trying to be responsive to these diverse external markets can be daunting. Effective managers must constantly strive to satisfy different, and sometimes incompatible, decision makers. The consumer, for example, may need extensive counseling, but the insurance companies involved in managed care can restrict the number of sessions they will pay for. Having multiple constituents presents an ongoing balancing act for most managers.

Effective managers are sometimes confronted with the dilemma of choosing between the organization’s mission and what the market wants and needs. If you start with the premise that the market is always right but that it may not be right for you or your organization, you have a choice not to meet the market’s needs—as difficult a choice as this may be. So a good starting point in assessing whether to consider a new service project or major expansion is to determine the following:17

•  Does the project support our mission?

•  Does it support or conflict with our organizational values?

•  Does it support our strategic plan, goals, and objectives?

•  Does it result in net income or net loss? If it is a loss, can we afford it?

•  Is this something we can do well?

•  Is there evidence of user need and interest?

•  Is there commitment to devote time and resources to the project?

•  Does the organization have the capacity to carry out the project?

The point, then, is that you need to move with the external markets when you can, but you must be careful about being so opportunistic in your quest for new programs or new funds that you allow the organization to drift from its mission. Be wary of mission drift, for it can create confusion among the organization’s key stakeholders and ultimately make the organization vulnerable. Sticking to the mission helps the organization resist chasing ideas and losing the organization’s core reason for existing.18 It may be difficult not to go after new sources of revenue, but this may be the best long-term decision for the organization.

It is crucial, however, that you tune in to what your external market determines and whether, in keeping with your mission, you need to provide a new program or redesign an existing one. When confronted with a situation in which consumers are not responding to your program, or public officials seem not to have an interest, or referring organizations are not making expected referrals, effective managers explore various avenues to determine what factors are preventing people from using their services. This is referred to as strategic marketing or as a marketing audit 19—special efforts designed to uncover information that can help you create or refashion your service program.

This is what a faith-based organization did to be responsive to its external markets in designing services: Catholic Charities Services Corporation (CCSC) of the Cleveland Diocese was a collection of 24 separate agencies that were held together in a loose federation. Because services were poorly coordinated and highly fragmented, the parent organization decided to integrate services in the eight counties in which it operated. To determine ways to improve its services, CCSC embarked upon a strategic marketing program in which the directors went outside the security and certainty of their own buildings to consider a broad range of services. They needed to shift from thinking that they intuitively knew what was needed to actually finding out what human needs existed and devising ways to meet those needs.

In addition to conducting interviews with service recipients, the management staff interviewed leaders of the private sector, such as United Way, and public sector administrative staff responsible for planning, developing, and purchasing services. For example, managers learned that county commissioners were desperately looking for ways to keep foster children under their care in their communities rather than send them to other counties for residential treatment. This awareness eventually led to specially designed community-based services for foster children.

Through strategic marketing, managers made adjustments to current services. For example, adolescents involved in domestic violence were being detained unduly in the juvenile detention home for long periods without any meaningful plan. CCSC contracted with local juvenile courts to work out a joint custody program with the teens and their parents. Being responsive to the requirements of the public agency has become central to the CCSC service design. Sometimes this involves working out ways to directly communicate with the public agency should problems occur. Probations officers, for example, are to be informed immediately if a youngster misses more than one day of counseling or if there are any other departures from behavioral expectations.

The consequence of the strategic marketing endeavor was to identify, from the public sector’s perspective, what populations were underserved because they cut across several different categories: juvenile offenders who are also substance abusers, disabled persons who also required employment opportunities, and substance-abusing mothers who wanted their children returned to them. This comprehensive approach to people with multiple problems encouraged CCSC to develop combinations of services geared to meeting multiple needs of their clients. Hence, chemical dependency counseling was made available to delinquent juveniles; employment counseling, as well as case management, was provided for persons with disabilities; and residential treatment and, eventually, job training were available for substance-abusing mothers.

To carry out the strategic marketing, staff received cross training so that they could work with a variety of clients. Staff could function both as specialists and as generalists. In addition, CCSC developed a capacity to subcontract with other programs that were not under the sponsorship of CCSC. For example, two of its agencies contracted with other neighborhood-based agencies to provide after-school programs. As a result of strategic marketing, CCSC staff shifted from being service presenters to becoming service responders. By being more responsive to the community needs, CCSC developed 111 new services totaling $8,000,000 in new revenue. This required a change in attitude from “what we have to offer” to “what the community needs.”20

SUMMARY OF ELEMENTS OF GOOD DESIGN

By incorporating elements from both the logic planning model and the marketing planning model, effective managers can prepare a service delivery system that would include the following:

1.  Services are consumer oriented. Staff have the authority to carry out meeting client needs or refer clients elsewhere. Client pathways are clearly understood. If clients need to receive multiple services, the organization provides for this. Whether within the agency or outside, all staff working on a case interact with each other through the computer network, teleconferencing, or joint meetings.

2.  The design clearly spells out outputs and, more importantly, the outcomes to be achieved. Special emphasis is given to demonstrating impacts at the conclusion of the program and, where feasible, at least six months or one year following termination.

3.  The design makes explicit assumptions and maintains a logical sequence of results if certain conditions are met. This takes the form of a series of “if A, then B” events. For example, if clients were to attend a minimum of 10 substance abuse group sessions, and if they could test negatively for substance abuse for 10 weeks, and if they could become gainfully employed in a job paying at least 10% above the minimum wage, then they would be considered drug free for one year following completion of the program.

4.  The program is designed with a marketing perspective, with special emphasis on being responsive to consumer needs. That is, the emphasis is on providing outstanding consumer service, including meeting total needs, where possible.

5.  New programs fit the organization’s mission and are feasible based on available or potential agency resources.

6.  The organization has good feedback mechanisms in the form of focus groups, formal and informal surveys, and client complaint procedures.

7.  The organization considers the needs of external markets, including, for example, the needs of public officials and funders. It would determine how best to balance the needs of the external markets with those of the consumers it is dedicated to serving.

QUESTIONS FOR DISCUSSION

1.  How does (could) your organization identify needs and opportunities for new services?

2.  In what ways could your organization use market analysis to deliver better services?

3.  A meeting has been called of representatives of United Way, the local mental health board, the developmental disabilities board, the county human services department, the local health department, the local substance abuse board, and the public schools. The intent is to explore whether to create a centralized intake system in several neighborhoods involving these organizations to serve multi-need families. What are the pros and cons of setting up a centralized office?

4.  Your agency provides counseling services to mentally ill persons who are able to function in the community but who also need jobs. What are the pros and cons of (a) offering job counseling and job finding through your agency, or (b) arranging to refer clients to another organization that is in the business of job development? If you decide to work with the employment organization, what would you need to consider to make the program work for the benefit of your clients?

5.  Develop a flowchart of clients going through your organization. Where are the dropout points likely to occur? What steps, if any, should your organization take to deter dropouts? At what critical points should the service consumers’ experience be assessed?

6.  How would you describe participants in your program? Are there any trends suggesting changes in the demographics of participants in the past few years?

7.  Does your organization currently evaluate its programs in relation to its proposed outcomes?