Outcomes for individual CHWs and programs also need to be measured for internal use. These measures can be used to assess performance, adjust workloads, and make program decisions, such as hiring additional staff. Most internal measures should cover program-related items, rather than health outcomes of clients. For example, it’s important to assess the number and types of interactions that CHWs have with clients. It’s also important to assess the time these interactions take. 

For example, if in-person visits generally take 60 minutes but clients from a particular referral source generally take 90 minutes, then workloads may need to be adjusted accordingly. Accompanying someone to a clinic appointment is much more intensive than simply sending them a text message. 

CHWs also can spend a substantial amount of their time completing documentation, traveling between locations, and in training. Keeping track of this time can help determine program inefficiencies. Being creative with measurement might be necessary. For example, mileage receipts can be used to track travel, and system logs might be able to track time spent documenting without adding additional burdens to CHWs and supervisors.