Results Based Accountability (RBA) A disciplined way of thinking and taking action that can be used to improve the quality of life in communities and the performance of programs and services. So what is RBA? A disciplined way of thinking and taking action that can be used to improve the quality of life in communities and the performance of programs, agencies and service systems Results-Based Accountability originated from the Fiscal Policy Studies Institute, in Santa Fe, New Mexico – it was established in 1996 to assist communities, cities, counties, states and nations working to measurably improve the well-being of their citizens.  Since then FPSI has worked with state and local partners, from the public and private sectors, in over 40 states and countries around the world, including the USA, UK and Canada. First encountered RBA in the fall of 2010 – the provincial Healthy Communities network hosted a RBA 101 workshop, led by Mark Friedmann, who developed the framework At the time, we weren’t ready to use RBA, but with the introduction of the Accountability Agreements from the Ministry of Health and Long-term care and the beginning of our new service delivery model, there is an opportunity for us to use RBA as a way to frame our Accountability Strategy.

Results Based Accountability is made up of two parts: For Communities For Cities & Counties For Provinces & Nations Population Accountability about the well-being of WHOLE POPULATIONS For Programs For Agencies For Service Systems Performance Accountability about the well-being of CLIENT POPULATIONS Introduction and the difference between population and performance accountability: The framework has two different kinds of accountability: Accountability for whole populations, like all children in Lanark, all seniors in Brockville, all residents of LGL. This first kind of accountability is not the responsibility of any one organization, agency or program. If we talk for example about “all children in our community being healthy,” who are some of the partners that have a role to play? Notice that the traditional answer is “It’s the health unit.” It’s got the word health in it and so it must be the responsibility of the health unit. And yet one of the things we have learned in the last 50 years is that the health unit by itself can’t possibly produce health for all children without the active participation of many other partners. And that’s the nature of this first kind of accountability. It’s not only about the health unit. It’s about the kind of cross community partnerships necessary to make progress on quality of life for any population. OPHS recognizes this by identifying societal indicators and stating that we are not solely responsible for achieving these. Now the second kind of accountability, is performance accountability, is about the health unit. It’s about the programs and services we provide, and our role as managers, making sure our programs are working as well as possible. OPHS board of health outcomes These are two profoundly different kinds of accountability. I will describe each of these types and how they relate to the Accountability Agreement indicators and I will discuss how they fit together.

Program Performance Measures Quantity Quality How much did we do? How well did we do it? Program Results Effect Effort Is anyone better off? Language of performance accountability, there were three types How much did we do? How well did we do it? Is anyone better off? The performance measure to correspond with these 3 types can be displayed in a 4x4 table that looks at Quantity and Quality against Effort and Effect. So a measure of quantity and effort would be how much did we do – a lot of counts (MPIQ and compliance report used to be) A measure of quality and effort would be how well did we do it – incorporate a cost component – efficiency measure. Measures of effect answer whether anyone is better of – the quantity is the # while the quality would be the percentage Measures of effect relate to client results, while measures of effort relate to program results Client Results # %