Resources

Measuring What's Real

A valid and reliable person-centered outcome quality improvement system builds upon the traditional quality measures of:

Input measures focus attention on resources such as physical environment, financial support, people and technology that are put into a program.

Process measures focus on how the inputs are used and arranged and described how the organization operates. Standards that require consumer choice in making employment decisions, specify team members interactions, and describe how planning decisions are recorded, reported and reviewed are process oriented.

Program outcome measures define the intended impact of resources and process. Program outcomes target goals, such as total number of work placements. While these measures may be preferable to input or process measures, they still contain the potential for targeting the wrong issues for the wrong people. Placing everyone in supported employment may sound like a great outcome, but not if it doesn’t match the needs and desires of the people being served.

PERSON-FOCUSED OUTCOMES, however, are different. They describe personal preferences. Outcome measures for people shift attention to the difference that the input and process activities have made on or for the person with the disability. For example, outcomes can be stated in terms of money earned, stability and security in setting, privacy, choice, satisfaction and goal attainment.

A specific program, service or support process is designed to produce outcomes. Consider for example, a vocational training program. The question to ask is “How well does the vocational training program assist people to achieve outcomes such as:”

Choosing where to work
Having friends
Participating in the community
Exercising rights
Being respected
Being safe
Having economic resources
Expanding social roles
Experiencing continuity and security
Being satisfied

These outcomes are what most people want from their work experience. Similarly, these and other outcomes are what people with disabilities want from residential, health, work, leisure, education, and other services.

The support and services provided by the public and private human service system are the methods or processes to enable people to reach those ends. As such, self developed and imposed criteria of effectiveness and efficiency can describe an organization’s processes. However, programs, as processes, should not be confused with ends and outcomes for people. Organizational effectiveness and efficiency fail as measures of outcomes for people because organizations often succeed at becoming more efficient and effective in accomplishing the wrong outcomes for individuals.