Module 2. Defining the Story You Want to Tell — PQMD Aligned Metrics Initiative

Before choosing an AMI impact area or metrics, get clear on what you are trying to understand, demonstrate, or decide.

The same program can tell several different stories. AMI helps you choose the one (or ones) most useful and realistic.

The right outcome indicators depend on what your organization is trying to achieve as well as on how the program actually operates.

What are you trying to understand?

Start with the question you actually care about.

What decision should your information support?

You may want to understand...Whether product support is aligned with priority demand

Because you are interested inDemand, planning, product mix, quantity, or timing

You may want to understand...Whether products are consistently available over time

Because you are interested inUnderstand product interruptions and continuity

You may want to understand...Whether product support is helping sustain or expand a health service

Because you are interested inKnowing what the products are enabling functionally

You may want to understand...Where gaps remain

Because you are interested inWhat additional support may be needed

You may want to understand...Whether a partnership model is working

Because you are interested inEffectiveness, roles, coordination, or investment

If you knew this, what might you do differently?

AMI supports decisions and keeps reporting focused on evidence that matters.

Collect information because it can help the program or partnership understand, decide, or act.

Design metrics to fit your decision needs and match your program

Your strategy matters. So does your operating reality.

Some programs have predictable supply, long-term partnerships, defined services, and repeated access to data. Others work across changing products, partners, and geographies with lighter downstream visibility.

Some programs will be able to measure across impact areas, some programs will not. Use these questions to ground the choice:

ConsiderStrategy and purpose

AskWhat is the program trying to achieve?

ConsiderMeasurement motivation

AskWhat value do we need to understand or demonstrate? Who needs to understand this?

ConsiderProgram model

AskHow predictable is supply? How consistent are products, sites, and relationships?

ConsiderPartnership conditions

AskDo we have enough shared planning and continuity to define and use the measure together?

ConsiderEvidence

AskWhat can we already see? What can we realistically observe over time?

ConsiderCapacity and burden

AskDo partners have the staff, systems, time, and resources to support the measure?

ConsiderTime and frequency

AskWhat period matters? How often can evidence reasonably be collected or reviewed?

These conditions guide fit. They do not create a hierarchy.

The useful measure is the one that fits the program's strategy, operating model, evidence, and decision needs.

Resource Theory of Change

Choose the strongest measure your program can credibly support.

Availability, continuity, and service capacity require different kinds of evidence.

AMI areaIncrease Availability of Priority Products

Often fits when...Priority demand and fulfilled supply can be understood, even with limited downstream visibility

AMI areaSustain Continuity of Care

Often fits when...Product flow is consistent enough to observe stock status over time at facility/product use level

AMI areaExpand Capacity to Deliver Care

Often fits when...Products influence service availability and service records and reporting are available through partnerships

Choose the strongest measure your program can credibly support and work towards the ones you can grow into. AMI measures are not a hierarchy. AMI will continue to expand and offer more outcomes measures, consider where you want to grow your measurement.

Tool 1 helps you to: think through measurement:

Strategy
intended outcome
operating model
partnership conditions
evidence feasibility
appropriate AMI measure
accompanying evidence

Use it to connect what the program is trying to achieve with what the program and partnership can credibly measure.

Tool 1

Story + Metric Selection Tool

This exercise is for teams that are ready to move beyond outputs. It assumes you already report core program activity - reach, partners, geography, product volume/value, and related outputs - and are ready to understand a deeper dimension of what those efforts contribute to.

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PQMD has established credible lines of contribution across medical product donation programs: availability of priority products, continuity of access over time, and product-supported service provision. Programs may also demonstrate outcomes in the quality of systems supporting products and care and, where the contribution pathway is sufficiently clear, specific health outcomes. Different programs will align with different outcome pathways.

1. Start with one program

Choose one program or program type for this exercise. Meant to be answered at the program level. At the core, what is this program trying to achieve?

What is this program trying to achieve?
What are you already able to show through outputs?
What deeper result do you want to understand?
What decision would better evidence help inform?
What is currently preventing you from understanding or demonstrating that result?

Keep this program and these questions in mind as you move through Steps 2-5. The purpose is to identify the strongest outcome pathway that reflects what this program actually does.

2. How does this program operate?

If your program looks more like this...Product placement across a broad partner networkThe program operates through many partner relationships, can respond to episodic opportunities, place changing products, and fill gaps with agility across locations or partners.

Consider...Consider what the program can demonstrate over time about whether priority products are reaching identified demand, closing important gaps, and extending access more equitably across partners, geographies, or populations.

If your program looks more like this...Repeated product and partner pathwaysProduct moves repeatedly through some of the same partner relationships, geographies, facilities, or program channels over time. Relationships and product flows have enough continuity to see patterns, even if supply is not fully predictable.

Consider...Consider whether repeated product and partner pathways allow you to understand availability and continuity over time. Are priority products more consistently available? Where do gaps persist? What does repeated support allow partners to rely on, plan around, or protect?

If your program looks more like this...Sustained product support with established local partnersThe program works consistently through established local partner relationships, with enough shared planning and visibility to understand how product access interacts with care delivery.

Consider...Consider what reliable product access enables within the local care context. Does it reduce interruptions? Support planning? Allow staff or resources to be used differently? Help maintain or restore care?

If your program looks more like this...Product support tied to a defined serviceProduct provision is deliberately connected to a specific service or care pathway, with enough consistency to understand whether that service is available over time.

Consider...Consider outcomes related to product-supported service availability. Has the program helped maintain, restore, expand, or newly enable the service?

If your program looks more like this...Product support with workforce developmentThe program includes training, competency-building, technical guidance, supervision, or other deliberate support to the people delivering care.

Consider...Consider what has changed in workforce capability because of that support. Can providers use the product safely and effectively? Has confidence, competence, or readiness changed in ways that matter to care delivery?

If your program looks more like this...Product support with systems investmentThe program deliberately strengthens systems or processes needed to manage, safeguard, distribute, maintain, or use products effectively.

Consider...Consider changes in the systems supporting donated products and care. These may include cold chain, storage, inventory, maintenance, forecasting, records, referral, supply-chain, or other relevant processes.

If your program looks more like this...Another pathwayYour program may create value through a pathway not captured above.

Consider...Describe what is distinctive about how the program works and what outcome would best reflect that contribution.

Health & Quality OutcomesSome programs may also have a sufficiently clear line of contribution to systems, workforce, quality of care, patient experience, or specific health outcomes. Keep that possibility in mind as you work through the exercise.

3. Connect your program to an impact area

Which outcomes reflect a credible line of contribution from this program? More than one outcome may be plausible.

Outcome pathwayIncrease Availability of Priority Products

What this helps you understandWhether, over time, the program is helping priority products become available against identified demand and close important product gaps across partners, geographies, or populations.

AMI priority outcome metricPercent of identified priority product demand met through available supply received by the local partner

Outcome pathwaySustain Continuity of Care

What this helps you understandWhether priority products remain available consistently enough to support care over time, including whether repeated support reduces interruptions or creates greater reliability.

AMI priority outcome metricPriority Product Stockout-Free Reporting Periods

Outcome pathwayExpand Capacity to Deliver Care

What this helps you understandWhether product support is connected to a change in volume of a defined product-supported service - maintained, restored, expanded, or newly available.

AMI priority outcome metricPercent change in volume of product-supported health services

Outcome pathwayOther pathway

What this helps you understandThe program may contribute to outcomes alongside or beyond these shared AMI impact areas. Use the outcome that best reflects the actual contribution.

AMI priority outcome metricUse a supporting outcome, health & quality outcome, or program-specific measure as appropriate.

The priority metrics provide a shared quantitative anchor. Supporting outcomes and qualitative evidence help explain why the result matters, what contributed to it, what changed for partners or services, and what the program may be enabling.

4. Take stock and identify any gaps

Reflect on the program todayWhat can we already support?

Use the reflection to identify...Which AMI outcome(s) can we already support with credible evidence?

Reflect on the program todayWhat do we want to understand more clearly?

Use the reflection to identify...Which outcome questions matter most now?

Reflect on the program todayWhat is getting in the way?

Use the reflection to identify...Data, access to information, consistency, definitions, time, partner alignment, program structure, resources, or another factor?

Reflect on the program todayWhat requires clarification?

Use the reflection to identify...Where may stakeholder expectations need to be clarified?

Reflect on the program todayWhat is worth strengthening?

Use the reflection to identify...Where could evidence, partnership, or the program itself deepen the contribution or make it more visible?

By the end of this step, identify: the outcome(s) you can credibly pursue now; the most important evidence or partnership gaps; expectations that may require clarification; and one or two areas where further action could strengthen the impact strategy.

5. Exploring next steps

Use the reflection above to identify the next actions that will strengthen the program’s impact strategy.

Strengthen the evidence

Build the smallest credible evidence set for the outcome question: a priority metric where relevant, supporting outcomes and outputs, and qualitative evidence that helps interpret the result. Choose the strongest measure the program can credibly support.

Strengthen the partnership

Identify where shared definitions, data, interpretation, capacity, or resources across partners could strengthen the evidence and its use.

Strengthen or explore the program

Where the program is not structured to demonstrate an outcome over time, strong outputs may remain the right story. Where deeper outcome learning is a priority, consider a defined subset, pilot, or program change that can be followed over time.

Next: Tool 2. Guide for Measuring in Partnership helps partners align on what to measure, what evidence already exists, what each partner can contribute, and a realistic plan.

Use findings for decisions

Review the priority result and the most relevant supporting outputs.
Look for differences across products, sites, partners, geographies, or periods where the data allow it.
Bring in qualitative evidence and local interpretation at the same level as the quantitative finding.
Identify plausible explanations and other factors that shaped the result.
Describe what donated products contributed without claiming they acted alone.
Ask what the evidence means for the project, partnership, local capacity, organizational strategy, and future investment.
Decide what to maintain, adapt, investigate, coordinate, complement, redirect, transition, or stop.
Document what is still unknown and what should be learned next.

Data is useful in every direction

PatternImprovement

What it may meanSomething may be working; identify what contributed and whether it can be sustained.

PatternMeaningful maintenance

What it may meanThe program may have protected availability or services under pressure; understand what prevented decline.

PatternStable high result

What it may meanThe current model may be sustaining a strong condition; determine what is needed to maintain it.

PatternStable low result

What it may meanA persistent constraint or mismatch may require adaptation, complementary support, or a different strategy.

PatternDecline

What it may meanInvestigate supply, demand, distribution, service, staffing, financing, or contextual factors; do not assume the donation itself is the only cause.

PatternVariation

What it may meanDifferences can reveal where the program works differently, where gaps are concentrated, or where definitions and data need review.

PatternNo clear change

What it may meanThe finding may still matter if the program prevented deterioration, or it may indicate that another factor is limiting impact.

One or two meaningful outcomes metrics will anchor a rich impact story; outputs, qualitative evidence, partner experience, program context, and objectives explain why the findings matter.

Next, we look at how AMI organizes contribution across the three impact areas.

Defining the Story You Want to Tell