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An organization-environment framework for assessing program implementation.

N Moss

    Evaluation and Program Planning
    |December 12, 1982
    PubMed
    Summary
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    Health program evaluations often overlook organizational factors. This study introduces a framework considering internal and external environments to predict health program success or failure, guiding future evaluations.

    Area of Science:

    • Health Services Research
    • Organizational Studies
    • Program Evaluation

    Background:

    • Traditional health program evaluations focus on client outcomes.
    • A rational bureaucratic framework often overlooks organizational implementation factors.
    • Understanding organizational consequences is crucial for program success.

    Purpose of the Study:

    • To propose a theoretical framework for analyzing organizational consequences of health program implementation.
    • To identify internal and external environmental factors influencing program success or failure.
    • To provide guidelines for process evaluation in health programs.

    Main Methods:

    • Comparative case study of two state-funded perinatal projects.
    • Utilized observational and structured interview data.

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  • Analyzed factors within internal (organizational) and external (community) environments.

    • Main Results:

    • External factors like service demand, competition, and social beliefs impact implementation.
    • Internal factors such as organizational commitment, conflict, and structural attributes (complexity, formalization, centralization, coordination) are critical.
    • One project was an organizational success, the other a costly failure, illustrating the framework's utility.

    Conclusions:

    • Health program success is significantly influenced by both internal and external organizational environments.
    • A comprehensive evaluation framework must integrate organizational factors.
    • The proposed framework offers theoretically-based questions for effective process evaluation.