How to measure progress or achievement of client outcomes

Being able to measure whether your clients have achieved or are making progress towards their goals (outcomes) is a key way of assessing the effectiveness of many community service organisations.

How do you measure these improvements when everyone is so different? To do this you need some way of recording information about how client’s lives have changed over the time they have been working with you.

This way of recording information needs to relate to the areas set out in clients’ individual support details (for example, their housing circumstances, employment participation, staying as well as they can, etc.) but it also needs to be consistent and comparable.

Here’s a step-by-step guide on how to do it.

What do we measure?

Everyone has different hopes and aspirations, but we need some way of drawing them together into general categories that will help you get an overall sense of the effectiveness of your service.

If you have government funding you may already have been given some ideas for general goals for organisations to use. They encompass a broad range of people’s needs and circumstances and could provide you with a useful way of categorising client information.

Clients’ outcomes could include changes to:

• physical or mental health, wellbeing or self-care
• knowledge and access to information
• skills or behaviours
• confidence to make own decisions
• engagement with relevant support services
• impact of a crisis
• personal and family safety
• age-appropriate development
• community participation and networks
• family functioning
• money management
• participation in education and training
• material wellbeing
• safe and affordable housing.

It could be relevant to look for changes in circumstances across three or four of these areas. Once you have decided which ones you think are relevant to the clients of your services you are ready to move to step two.

How do we make it relevant to our service?

You can take these broad categories and relate them to the work you do; your indicator of achievement can be the proportion of clients who are achieving goals relevant to your service delivery.

Here are some examples:

Individualised support / case management	The proportion of clients making progress towards or achieving their individual goals or resolving issues they sought assistance for.
Intake and assessment	The proportion of clients who are better connected to relevant services to meet their immediate needs. The proportion of clients reporting they are better informed about their choices.
Information, advice, community education	The proportion of individuals or organisations reporting they have improved awareness or knowledge; improved capacity; or improved commitment to implement desired changes.
Advocacy	The proportion of individuals offered advocacy support who report they understand their rights or options better; they are better able to make informed decisions; they have more confidence in influencing decisions about their life.

When do we measure?

You need to decide when you are going to gather information. Does your service provide one-off assistance, or time-limited assistance? If yes to either of these, it might be best to just record the clients’ circumstances when they finish using your service.

If you work with clients for longer you may need to identify where they stand in relation to achievement of their goals when you start work with them and then again when they stop using your service or program.

If your work is intensive, or ongoing, it would be useful to record progress towards achieving clients’ goals at periodic case reviews.

How do we measure it?

To measure the achievement of client goals you need some way of recording information about an individual’s progress while they are using your service that is reliable, consistent and comparable.

There are four ways to go when deciding how to measure changes in a client’s circumstances.

1. Use an existing tool, often called a ‘scale’ or ‘instrument’, which will measure your clients’ changes in numbers.
2. Create your own tool to measure your clients’ changes in numbers.
3. Use your service data.
4. Don’t use numbers – use your clients’ story to create a case study.

Using an existing tool to measure change in numbers

There are lots of these tools already in existence that you could choose from. For example, in the mental health area there are a number of tools that have been developed to measure people’s recovery from mental illness.

• The Stages of Recovery Instrument (STORI) is designed to capture change across five stages of recovery from a consumer’s perspective (moratorium; awareness; preparation; rebuilding; and growth).
• The Outcomes Star (Recovery Star) also assesses consumers’ progress towards recovery from their own perspective. It does this across 10 areas (managing mental health; self-care; living skills; social networks; work; relationships; addictive behaviour; responsibilities; identity and self-esteem; and trust and hope.)

For a list of assessment tools in the various areas of community sector work see The TasCOSS Outcomes Monitoring Tool Box. It’s a library of off-the-shelf measurement tools.

Create your own tool to measure your clients’ changes in numbers

You might find the ratings scale called the ‘Standard Client Outcomes Reporting (SCORE) helpful, it looks like this:

Rating = 1	Rating = 2	Rating = 3	Rating = 4	Rating = 5
Significant negative impacts on client’s circumstances	Moderate negative impacts on client’s circumstances	Progress towards improving impacts on client’s circumstances	Short-term positive impacts on client’s circumstances	Ongoing positive impacts on client’s circumstances
No progress in achieving this outcome				Outcome fully achieved

When this tool is used to measure outcomes it starts to look like the table below. (We’re using the example of clients’ circumstances in the area of mental health, well-being and self-care.)

A tool to measure changes in clients’ circumstances in the area of mental health, well-being and self-care

Rating = 1	Rating = 2	Rating = 3	Rating = 4	Rating = 5
Significant negative impact of poor mental health, well-being and self-care on independence, participation and well-being	Moderate negative impact of poor mental health, well-being and self-care on independence, participation and well-being	Progress towards improving mental health, well-being and self-care to support independence, participation and well-being	Adequate short-term mental health, well-being and self-care to support independence, participation and well-being	Adequate ongoing mental health, well-being and self-care to support independence, participation and well-being

But if you think you need something purpose-built for your service or program you might need to create your own tool from scratch. If that’s the case, see How to create and use ratings scales.

Use service data

You can use your service data to report on changes in clients’ circumstances. For example, you could report on the number of clients accommodated, or the number still in housing after six months or the number maintaining self-care plans.

Create a case study

If you don’t want to quantify this work you can use a client’s story to create a case study – see How to write a case study. (But remember that funders really want measurable information.)

I want to use clients’ stories:

If that’s the case, see How to do a semi-structured interview or How to plan and run a focus group.

Analyse and report on your findings

Now you’ve done the hard work, the next step is to analyse your results and report on them. For tips on this see:

• How to analyse and report on quantitative information (numbers)
• How to analyse and report on qualitative information (stories)