Here we take the term ‘outcome’ to describe the results after-the-fact. An ‘objective’ is a target set in advance. Clearly the intent is to set objectives to achieve particular outcomes.
There are many things that would initially seem to be good outcomes – Taking some current examples from the UK National Health Service: waiting time for elective surgery, time in Accident and Emergency before being seen by a doctor – these are both things that would obviously be good to reduce.
Managers devise objectives to focus attention and drive behaviours . These can be good and effective but the problem with transforming desirable outcomes into objectives is that the desired outcomes are often a bit more sophisticated and nuanced than we first imagine. We want certain things, but not to the detriment of other things. Well-meaning and diligent staff – under pressure – will find ways to meet objectives – but often in ways with unintended consequences.
A possible bad outcome could include only doing quick, simple operations. Waiting lists would reduce but the most serious cases (and ones probably with the greatest beneficial impact) would be stopped.
It may be suggested that tighter definitions for the measures would address these issues but I suggest these would actually make things worse. Apart from the practicality of the detail required (see written instructions can never be enough) it constrains the most caring and expert practitioners from exercising their clinical judgment for the benefit of all. Instead they get immersed in ‘optimising’ the reports.
Other examples that have been alleged in the UK media recently:
- Foreign office staff opening emails (without reading them) regarding people wanting to leave Afghanistan so they can report that all emails were opened.
- Police reluctant to record crimes so that crime figures appear better.
(see Beneficial Outcomes and Reuse is a poor objective [relating to software development])
Heritage: The distinction between desirability of result and suitability of the objective was an insight documented by CSC Research Services in mid 1990s.