The ecology of outcomes: system accountability in children's mental health.
This article provides a conceptual and practical framework called the Ecology of Outcomes. Based on this framework, agencies that serve children and families build and use outcome-oriented information systems to respond to their clients in a more flexible manner. The goal is to improve promising programs by involving stakeholders in outcome identification and in utilization of results. Problems addressed include the emphasis human services place on rules compliance, lack of feedback to program staff to allow for midcourse correction, and lack of input by key stakeholders in the identification of outcomes to be measured. The following components of the framework are described: principles of outcome accountability, prerequisites and building blocks, implementing an outcome information system, and utilizing the results. Key elements of the framework are the integration of outcome information into a service system's decision-making process and the inclusion of client, stakeholder, and provider satisfaction information.
Hernandez
M
M
Department of Child and Family Studies, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa 33612-3899, USA. hernande@hal.fmhi.usf.edu
Hodges
S
S
Cascardi
M
M
D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000592:standards*; D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards*; D003659:Decision Making, Organizational; D005246:Feedback; D006801:Humans; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000458:organization & administration*; D017060:Patient Satisfaction; D015397:Program Evaluation; D011635:Public Health Administration / Q000592:standards; D012941:Social Responsibility; D013597:Systems Analysis; D013781:Texas