Focusing on the Outcomes That Matter Most

By aligning its transformation efforts with six priority areas, Georgia's most populous county is seeing early progress.

Cities are often hailed as hotbeds of public-sector innovation, bringing new ideas to bear in the face of resource constraints and rising citizen demands while seizing on new opportunities provided by emerging technologies. But counties also have the potential to play a large role in fostering and expanding the effectiveness of local government.

Fulton County, with approximately one million residents, sits at the heart of the Atlanta metropolitan area. In 2015, our county leadership embarked on a strategic planning and organizational transformation effort, working with consultants to recast our planning process, shape a four-year strategic plan to set a clear path for management, increase transparency and forge new collaborations.

Nearly two years into this strategic overhaul, three key areas of emphasis showcase our approach and progress: the assignment of key performance indicators to each of our strategic goals, a laser focus on shifting the county's overall governmental culture, and telling our story through transparency and citizen-engagement efforts.

To invigorate aspirational thinking, the county kicked off its overhaul effort with a facilitated strategic planning session to define the critical, resident-centric outcomes around which to focus county operations and to identify the key principles that would drive the transformation of our government. What emerged was a management-centric initiative to deliver significantly better impact, service and efficiency within six priority areas: public safety, health, self-sufficiency, cultural and recreational enrichment, economic opportunity, and trust in government.

A countywide survey of residents and input from front-line employees fueled an iterative process that enabled county commissioners to zero in on key performance indicators that were not limited to measuring outcomes for services that the county directly provides but also took in success factors that mattered to citizens. Those included such indicators as the rate of new HIV diagnoses, average emergency-room wait times, and the percentage of residents who say they trust the county government.

In an orchestrated shift to help change our overall organizational culture, a new approach enlisted each member of the county board of commissioners to "take ownership" of one of the six priority areas. the county reoriented board-meeting agendas to organize items by strategic priority area so that discussions about investment decisions could take place in the proper context. Every other month, we dedicate the second board meeting to one of the six priority areas. A redesigned budget process aligned the county's billion-dollar annual spending plan more directly with the strategic priorities.

Perhaps most significantly, Fulton County has implemented a robust, citizen-facing performance-management system with an open-data platform to increase transparency and help share success stories and goals. For instance, more than 25 percent of people jailed in the county suffer from mental-health problems. By combining two strategic initiatives, one that outsourced behavioral health services and another that targeted funding to a justice reinvestment initiative aimed at streamlining court procedures and reducing recidivism, Fulton County aims to reduce the number of people with mental illness and substance abuse issues who wind up in jail. While still in their infancy, both efforts have well defined performance objectives as well as key performance indicators that we publish to our citizens.

In another example, the county's cross-jurisdictional collaboration with a state agency helped Fulton propel from a missed handling of a tuberculosis outbreak to garner a 2017 award for management of TB cases from the federal Centers for Disease Control and Prevention.

The establishment of the six citizen-focused strategic priorities has supported a fundamental shift from a culture of administrative control to one driven more by accountability to produce meaningful outcomes. There is greater collaboration among elected officials, county leaders and key internal and external stakeholders. This focused effort is proving to be an increasingly successful one that Georgia's most populous county plans to continue to capitalize on for years to come.