Why do we continue to see evidence that nonprofit staff feel like outcome measurement is missing important aspects of their work? Based on an analysis of over 1,000 pages of material in 10 outcome measurement guides and a focused literature review of frontline work in three types of nonprofit organizations, this article shows that existing outcome measurement frameworks focus on how staff implement programs rather than how staff work with clients. Outcome measurement guides direct nonprofits to track program activities completed and the outcomes resulting from those program activities. In contrast, the accounts of frontline work in nonprofits show that nonprofit staff start by building a relationship with the person they are serving and then adjusting programs and services to better meet the needs and goals of this individual. Consequently, outcome measurement may go some distance in helping us understand nonprofit performance but may also mischaracterize nonprofit performance. (Contains 2 tables.)