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Demonstrating Performance: A Primer for Expenditure Reviews (June 2008)

Condition #5: Delivery Meets Quantity and Quality Standards

Good delivery makes good results possible. Effective delivery must be demonstrated. Both the Public Finance Act (s41) and Crown Entities Act (s142) require agencies to describe outputs, provide measures and standards, and report on delivery.

Effective Delivery.

Three dimensions of delivery can be reported against the output specification (plans) for major interventions:

  1. Quantity
  2. Quality
  3. Coverage (discussed separately in #6).

Quantity measures are widely reported in New Zealand. This brief document will not review their use.

A far greater challenge is to show that delivery met expectation. Without assurance on output quality, users and stakeholders may refuse to use services, compliance and claimed benefits are less likely or likely to be reduced, efficiency is un-provable, and value-for-money is reduced.

Quality can be assessed in three main ways:

  • Against surrogate measures, typically intermediate outcomes, drawn from the logic model (eg, completion rate; readmissions; 90 day survival rates; user satisfaction).
  • Against delivery attributes in the output specification (eg, timeliness; checklists).
  • Process evaluation (where quality criteria are poorly specified or hard to specify).
HNZC Property Condition Benchmark
(properties meeting it)
HNZC Property Condition Benchmark(properties meeting it).
Mortality Rates Down – Quality Inferred
(National healthcare quality report 2005, USA)
Mortality Rates Down – Quality Inferred(National healthcare quality report 2005, USA).

Remember that delivery measures only show delivery met specification or expectation:

  • Surrogates provide good, cost-effective measures as: (a) intermediate outcomes provide some assurance that interventions worked, (b) meticulous documentation and review of outputs are not needed, and (c) results are valued by delivery staff.
  • Direct measures of delivery quality may be costly, or may be resisted by staff.
  • Process evaluation should establish quality measures for reporting into the future.
  • Claims of efficient cost management (#4) are only credible if quality was maintained.
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