GPRA helped create a governmentwide focus on results by establishing a statutory framework for performance management and accountability, with the necessary infrastructure to generate meaningful performance information. GPRA introduced planning and reporting requirements that seek to shift the focus of federal management and decision making from a preoccupation with the number of program tasks or activities completed or services provided to a more direct consideration of the results of programs. The Act was intended to improve federal program effectiveness, accountability, and service delivery. GPRA requires federal agencies to develop strategic plans with long-term, outcome-oriented goals and objectives, annual goals linked to the long-term goals, and annual reports on the results achieved. Agencies are required to measure progress toward the achievement of the goals in annual performance plans and report annually on their progress in program performance reports. As we reported in our 10-year retrospective report on the effectiveness of GPRA, the Act’s requirements have laid a solid foundation of results- oriented agency planning, measurement, and reporting that has begun to address the purposes of GPRA. Performance planning and measurement have slowly yet increasingly become a part of agencies’ cultures. According to three government-wide, random sample surveys of federal managers conducted by us in 1997, 2000, and 2003, managers reported having significantly more of the types of performance measures called for by GPRA, particularly outcome-oriented performance measures, in 2003 than in 1997, when GPRA went into effect governmentwide. The benefit of collecting performance information is only fully realized when this information is actually used by managers to make decisions oriented toward improving results. While our surveys found that managers reported having more performance measures in 2003 than in 1997, the data showed that the use of performance information for program management activities did not increase significantly from 1997 levels. In our survey, we asked managers about their use of performance information for specific purposes, such as “setting program priorities”, “allocating resources”, or “adopting new program approaches.” As shown in figure 3, the majority of managers who expressed an opinion reported using performance information for these uses to a great or very great extent in 2003. While the reported use of performance information for these uses to a great or very great extent fluctuated somewhat between 1997 and 2003, the extent of use in 2003 was not significantly different from 1997 levels for any category of use except “adopting new program approaches or changing work processes”, where use actually decreased. From our 2000 survey, we also know that use of performance information has varied widely among agencies. For example, while 56 percent of managers overall reported using performance information when setting program priorities in 2000, the percentage of managers within specific agencies reporting this use to a great or very great extent ranged from 26 percent to 64 percent. Similarly, wide variation among agencies was seen in managers’ reported use of performance information for other types of management decisions. For example, the reported use of performance information to a great or very great extent in agencies ranged from 24 to 66 percent when allocating resources, from 25 to 64 percent when adopting new program approaches or changing work processes, and from 16 to 66 percent when setting individual job expectations. Federal agencies can use performance information to make various types of management decisions to improve programs and results. We have previously reported that leading organizations that have progressed toward results-oriented management use performance information as a basis for decision making. The full benefit of collecting performance information is realized only when managers actually use it to manage. From our review of the literature, agency documents and interviews with experts and agency officials, we identified four categories of management decisions for which federal agency managers can use performance information. (See fig. 4). Managers can use performance information to identify problems in existing programs, to try to identify the causes of problems, and/or to develop corrective actions. They can also use program performance information to develop strategies, plan and budget, identify priorities, and make resource allocation decisions to affect programs in the future. Agency managers can also use performance information to reward individuals or organizations who meet or exceed expectations. Finally, managers can use performance information to identify more effective approaches to program implementation and share those approaches more widely across the agency. Agencies can use performance information to identify problems or weaknesses in programs, to try to identify factors causing the problems, and to modify a service or process to try to address problems. We have reported that leading organizations that have progressed toward results- oriented management have used performance information to identify gaps in performance, improve organizational processes, and improve their performance. We found several examples where federal program managers used performance data to identify problems and corrective actions at the agencies we examined. Officials in the Office of Participant Assistance (OPA) at the Employee Benefits Security Administration (EBSA) in the Department of Labor (DOL) told us that when data for a performance measure of customer satisfaction indicated a problem, they changed a process to try to improve performance. One of EBSA’s functions is to provide information and assistance for individuals covered by private retirement and health and welfare plans, plan sponsors, and members of the employee benefits community. EBSA has contracted with an outside organization since 2003 to collect data through a specialized survey on customer satisfaction with EBSA services. Data indicated that customers whose cases were referred to the enforcement side of EBSA were reporting lower satisfaction rates. An analysis of data for specific survey questions identified the need for improved communication. Investigating an inquiry or complaint could sometimes take up to 2 years, and a customer might not receive any information during that time. As a result of the performance data, EBSA changed a standard operating procedure in January 2005 so that customers would be kept informed about the status of their open inquiries or complaints. Under the new procedure, when an inquiry is referred to the enforcement staff for investigation, the OPA benefits advisor informs the inquirer about the referral and sets realistic expectations for future contact by an investigator. Investigative staff are to make initial contact with the customer no later than 30 days following receipt of the referral and maintain contact with the inquirer on a quarterly basis until the matter is resolved. Managers plan to continue to monitor customer satisfaction to see whether the changes lead to improved performance. Through the Performance Enhancement Project (PEP), the Office of Workforce Investment in DOL has used performance information to identify the technical assistance needs of state and local employment and training programs and has then provided targeted assistance to try to improve performance. The PEP project, which began in October 2002, has provided technical assistance and training for targeted state and local workforce organizations that receive funds under the Workforce Investment Act (WIA). Poorly performing states, as shown by the performance measures (supplemented by analysis from regional DOL staff), have received technical assistance designed to improve their performance through PEP. DOL’s Office of Workforce Investment sent a questionnaire to all the regional offices and held a conference with them at the close of the first PEP project to assess the effectiveness of the technical assistance that had been given. This information was used to improve the second year’s project. Online tutorials have also been developed under PEP in response to requests from states. Officials in the Veterans Health Administration (VHA) network that includes facilities located in Maryland, Virginia, West Virginia, and Pennsylvania, stated that in response to one of the network facilities not meeting the heart failure performance measure target, all of the facilities adopted a new process to improve the network’s performance. According to an official, in the first quarter of 2004, the network was at risk of not meeting the entire set of 10 cardiovascular performance measures if one of its facilities did not improve its low score on the heart failure performance measure by the end of the year. The heart failure performance measure is a cumulative performance measure that assesses whether discharged heart failure patients receive six types of instructions, including instructions for monitoring weight after discharge and taking medications. The instructions are critical because patients’ noncompliance with physicians’ instructions is often a cause for rehospitalization. An agency official stated that the entire network implemented a new set of mandatory data fields in patients’ electronic medical records. The data fields include the six types of instructions and have to be filled out when a facility discharges a heart failure patient. According to this official, the result of the implementation of the new mandatory fields in the patients’ electronic records was that the facility that was not meeting the heart failure performance measure target in the first quarter improved its score to the “fully satisfactory” category in the fourth quarter. Agencies can use performance information to make decisions that affect future strategies, planning and budgeting, identifying priorities, and allocating resources. We have previously reported that outcome-based performance information should be used for the allocation of resources and in deciding among competing priorities in a results-oriented management system. In addition, linking cost with performance information infuses performance concerns into planning and budgetary deliberations, prompting agencies to reassess their performance goals and strategies and to more clearly understand the cost of performance. Performance information also allows program managers to compare their programs’ results with goals and thus determine where to target program resources to improve performance. When managers are faced with reduced resources, the same analysis can help them target reductions to minimize negative impacts on program results. We found a number of examples among our case agencies of managers using performance information to identify priorities and allocate resources, and to shape future program strategy. The National Highway Traffic Safety Administration (NHTSA) has used performance information to set priorities in budgeting and to target resources. The Senior Associate Administrator for Traffic Injury Control annually sends out a memo that identifies agency priorities that support the Department of Transportation’s (DOT) strategic goals and are based on performance information for traffic-injury-related measures, such as safety belt use and impaired driver rates. The memo directs managers to focus their programs and proposals to support these priorities. In addition, NHTSA used performance information on alcohol-related injuries and fatalities to target grant funding and specific program strategies to states with the highest impaired driver rates.