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Real People Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act (1995)
Institute of Medicine (IOM)

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. "Effectiveness of the State Long-Term Care Ombudsman Programs." Real People Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act. Washington, DC: The National Academies Press, 1995.

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Real People Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act

to residents and community, (b) investigate and resolve complaints, (c) convince providers and state unit on aging (SUA) directors of the program’s usefulness, and (d) manage human (volunteer) resources. These findings do not necessarily provide unequivocal evidence of program effectiveness. Rather, they suggest the program is very likely attaining several of its goals in selected areas and in selected locations. Hence, they provide the basis for the formative nature of this evaluation and the nature of the committee’s recommendations. The chapter ends with a series of recommendations intended to improve the capacity of the national and the state programs. Specifically, after recommending that Congress continue the program and that the federal government implement an objective method of compliance review, the committee recommends five ways the program’s data collection and information system can be improved. One recommendation is made to enhance the management of volunteers.

EVALUATION CONTEXT

Evaluation Strategy: Formative and Summative Evaluations

Although the ombudsman program has been in varying stages of implementation over the past 20 years, ombudsmen themselves, researchers who have studied various aspects of the program, and experts who served on the committee concur that the program has not stabilized or achieved complete implementation in all states. Further, in those states where it has been fully implemented, data on program effectiveness are often imprecise and far from comprehensive. These realities led the committee to adopt a formative evaluation strategy.

Formative evaluation is geared toward improving program performance by providing feedback on substantive operational dimensions of the program (Scriven, 1991). It suggests a framework for ways to improve processes and data, including ways to provide data useful for assessing effectiveness. Formative evaluation can point the way to hypotheses that may be tested in a later summative evaluation. Because its goal is to assist in producing positive changes to improve the functioning and data reporting system of a program (Stadish et al., 1991), formative evaluation is more appropriate to the ombudsman program than a summative evaluation would be.

Summative evaluations judge program worth by assessing program effects or impacts. They are appropriate when a program is fully implemented and evidence of stabilization and institutionalization (e.g., adequate infrastructure and full implementation) can be found. The committee recognized that, given the state of the data, the state of the field, and the variability in stages of program implementation across the states, a summative evaluation of this sort was not appropriate.

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