The Quality Management Division of SCDDSN offers to service providers consultation, training and technical support focusing on personal outcome measures, training, organizational performance and continuous quality improvement.
We are committed to supporting you and your agency as you strive for organizational excellence. Let us know your specific needs and we will gladly work with you at your site.
DDSN is constantly monitoring “best practices” and emerging trends on a nation-wide basis. An important example of this effort is the “Reinventing Quality” Project, a three-year collaborative undertaking of the National Association of State Directors of Developmental Disabilities Services (NASDDDS), The Human Services Research Institute (HSRI), and the Institute on Community Integration at the University of Minnesota (ICI/UM).
After significant efforts at including stakeholders in discussions over a period of days, a “Consensus Statement” emerged setting forth ten principles that should guide the operation of a system of quality, person-centered, consumer-directed, outcome oriented community support. These principles represent a good summary of the system of the future that DDSN is striving to develop.
REINVENTING QUALITY CONSENSUS STATEMENTS
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PERSON CENTERED
Each person shall have the authority to define and pursue his or her own vision. Person-centered supports start with listening to the person and honoring each person’s vision. The individual’s vision must be honored, respected, and supported. The goal must be to promote each person’s empowerment, dignity, and positive self-image.
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CONSUMER CONTROLLED
Self-determination is a must. People and families are entitled to the freedom, authority, and support to control, direct, and manage their own services, supports and funding. Individuals and families have the right to select their own services and supports as well as decide how and by whom supports are provided.
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COMMUNITY INCLUSIVE
Personal relationships and community membership are valued. It is absolutely vital to promote the inclusion, presence, and participation in community life for all individuals, at all ages and across all dimensions of life. People must be supported in their social and spiritual life, friendships, and intimate relationships.
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CIRCLE OF SUPPORT
All networks and systems of support must collaborate in support of the person’s vision. Families, neighbors, friends, co-workers, and classmates play important roles in the lives of people with developmental disabilities. These rich, vibrant networks of support connect people to their communities. Public systems must work hand-in-hand with these networks in supporting individuals.
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FULL PARTICIPATION
People and families must participate as valued and empowered partners in all decision-making. People and families must have meaningful leadership roles at all levels. It is crucial that government, providers, and community organizations welcome, listen to and collaborate with people and families in solving problems, making decisions, and pursuing excellence.
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MEANINGFUL WORK
Individuals must have supports to contribute to their communities and engage in meaningful work. People with developmental disabilities want to and can make valuable contributions to their communities. There must be supports that assist people to make a difference. Youth and adults must be supported to have real jobs, earn money, or run their own businesses.
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FAMILY INVOLVED
Families are supported and valued. Families support people with developmental disabilities of all ages. Support networks must partner with families and offer critical services that not only address the needs of the family member with a disability but also support and strengthen the family itself. The unique needs and preferences of each family shall be acknowledged, respected, and accommodated.
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SUPPORT AVAILABILITY
All people and families must have access to supports when and, as they need them. Every individual must have easy and timely access to vital services and supports in order to achieve his or her personal vision and enjoy quality of life. There will be energetic outreach to all our nation’s diverse communities so that they can access supports on their own terms.
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PERSONAL SECURITY
The personal security and well being of people must be ensured. People must be secure in their own lives. They must not be exposed to neglect, abuse, or exploitation. They must have high quality health care. Ensuring the personal security and well being must not sacrifice the right of individuals to live everyday lives of their choosing in the community, exercise choice and pursue their dreams and aspirations.
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CONTINUOUS QUALITY IMPROVEMENT
There must be a resolute, continuous commitment to achieve excellence in all dimensions of supporting individuals and families. High quality services enable people to realize their vision. Excellence in person-centered supports demands a strong, sustained commitment to securing and maintaining a high quality workforce, ongoing training and education, and continuous quality improvement. Individuals and families are essential partners in promoting excellence.
(Excerpted & adapted from “Person-Centered Supports- They’re for Everyone!” National Association of State Directors of Developmental Disabilities Services, Inc., December 2000)
CONSULTATION & TECHNICAL ASSISTANCE
Consultation and/or technical assistance focusing on organizational performance and continuous quality improvement is available to your agency.
The Division of Quality Management is committed to support ing you and your agency as you strive for organizational excellence. Let us know your specific needs and we will gladly work with you at your site.
Contact Quality Improvement at 803.898.9691
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SCDDSN Quality Management
Historically, measures of quality were often far removed from the actual impact in the lives of the consumers of the services. Agencies would focus on “process measures” rather than “outcome measures”, since they were often easier both to measure and to control. If the administrative and programmatic processes, protocol, procedures and paperwork were in place, then the quality of service was assumed.
Over time measures of quality shifted from “processes” to “outcomes,” but still the focus was often on what the agency could measure and control best, and this was not the consumer. Under this model, quality was assumed by measures of service objectives written, or units of service delivered.
It has only been recently in the evolution of the nation’s long term care system that quality measures have started to become personalized and individualized relative to specific consumers.
DDSN strives to use personal outcome measures to determine how well the service and support providers are helping an individual consumer achieve personal goals. Activity in this area is based on the work of The Council on Quality and Leadership.
Personal outcome measures are often founded on goals that the individual has set for themselves in conjunction with their family and their “circle of support”. They are thought about and discussed, hopefully weighed against alternative goals and decided upon. To this degree they are objective and “matters of the head”.
On the other hand, measures of consumer satisfaction have a larger affective component; satisfaction is a “matter of the heart”. It is very possible for a consumer to have met all of his personal outcome measures, but still feel dissatisfied with his life or the services and supports that he is receiving. Thus, measures of consumer satisfaction must go hand in hand with personal outcome measures in order for an agency to be truly consumer- focused and driven.
Consumer satisfaction surveys are conducted periodically with consumers, families and other stakeholders. DDSN and service providers use this information to improve services and make them more responsive to consumers’ needs and wishes.
Personal Outcome Measures 2005SM
The 21 Personal Outcome Measures focus on the outcomes of the person receiving services. By placing the person at the center the definition of quality is responsiveness to the person rather than how well the organization performs. The Personal Outcome MeasuresSM are a powerful tool for evaluating quality of life and the degree to which organizations individualize supports to facilitate outcomes.
MY SELF
– People are connected to natural support networks.
– People have intimate relationships.
– People are safe.
– People have the best possible health.
– People exercise rights.
– People are treated fairly.
– People are free from abuse and neglect.
– People experience continuity and security.
– People decide when to share personal information.
MY WORLD
– People choose where and with whom they live.
– People choose work.
– People use their environments.
– People live in integrated environments.
– People interact with other members of the community.
– People perform different social roles.
– People choose services.
MY DREAMS
– People choose personal goals.
– People realize goals.
– People participate in the life of the community.
– People have friends.
– People are respected.
©Copyright 2005, The Council on Quality and Leadership (CQL)
Basic Assurances SM
The Quality Measures 2005
Developed by The Council on Quality and Leadership
Factor One: Rights and Protection and Promotion
Indicators:
A. The organization implements policies and procedures that promote people’s rights.
B. The organization supports people to exercise their rights and responsibilities.
C. Staff recognize and honor people’s rights.
D. The organization upholds due process requirements.
E. Decision–making supports are provided to people as needed.
Factor Two: Dignity and Respect
Indicators:
A. People are treated as people first.
B. The organization respects people’s concerns and responds accordingly.
C. People have privacy.
D. Supports and services enhance dignity and respect.
E. People have meaningful work and activity choices.
Factor Three: Natural Support Networks
Indicators:
A. Policies and practices facilitate continuity of natural support systems.
B. The organization recognizes emerging support networks.
C. Communication occurs among people, their support staff and their families.
D. The organization facilitates each person’s desire for natural supports.
Factor Four: Protection From Abuse, Neglect, Mistreatment and Exploitation
Indicators:
A. The organization implements policies and procedures that define, prohibit and prevent abuse, neglect, mistreatment and exploitation.
B. People are free from abuse, neglect, mistreatment and exploitation.
C. The organization implements systems for reviewing and analyzing trends, potential risks and sentinel events including allegations of abuse, neglect, mistreatment and exploitation, and injuries of unknown origin and deaths.
D. Support staff know how to prevent, detect and report allegations of abuse, neglect, mistreatment and exploitation.
E. The organization ensures objective, prompt and thorough investigations of each allegation of abuse, neglect, mistreatment and exploitation, and of each injury, particularly injuries of unknown origin.
F. The organization ensures thorough, appropriate and prompt responses to substantiated cases of abuse, neglect, mistreatment and exploitation, and to other associated issues identified in the investigation.
Factor Five: Best Possible Health
Indicators:
A. People have supports to manage their own health care.
B. People access quality health care.
C. Data and documentation support evaluation of health care objectives and promote continuity of services and supports.
D. Acute health needs are addressed in timely manner.
E. People receive medications and treatments safely and effectively.
F. Staff immediately recognize and respond to medical emergencies.
Factor Six: Safe Environments
Indicators:
A. The organization provides individualized safety supports.
B. The physical environment promotes people’s health, safety and independence.
C. The organization has individualized emergency plans.
D. Routine inspections ensure that environments are sanitary and hazard free.
Factor Seven: Staff Resources and Supports
Indicators:
A. The organization implements a system for staff recruitment and retention.
B. The organization implements an ongoing staff development program.
C. The support needs of individuals shape the hiring, training, and assignment of all staff.
D. The organization implements systems that promote continuity and consistency of direct support professionals.
E. The organization treats its employees with dignity, respect and fairness.
F.
Factor Eight: Positive Services and Supports
Indicators:
A. People’s individual plans lead to person-centered and person-directed services and supports.
B. The organization provides continuous and consistent services and supports for each person.
C. The organization provides positive behavior supports to people.
D. The organization treats people with psychoactive medications for mental health needs consistent with national standards of care.
E. People are free from unnecessary, intrusive interventions.
Factor Nine: Continuity and Personal Security
Indicators:
A. The organization’s mission, vision and values promote attainment of personal outcomes.
B. The organization implements sound fiscal practices.
C. Business, administrative and support functions promote personal outcomes.
D. The cumulative record of personal information promotes continuity of services.
Factor Ten: Basic Assurances System
Indicators:
A. The organization monitors Basic Assurances.
B. A comprehensive plan describes the methods and procedures for monitoring Basic Assurances.
Shared ValuesSM
The Quality Measures 2005
Organizational values drive organizational behaviors
Collective values shape organizational culture
Organizational culture assures which options are available to people
Values Alignment
•Determine link between values and practice
•Identify values for a future vision
•Establish immediate and long term action strategies to put values into action
Bridging Organizations and Social Capital
•Organizations as bridges between people and their communities
•Importance of social capital for all members of the organization
– People receiving supports
– Families and volunteers
– Employees
– Community
Self Determination and Choice
•People direct decisions that impact their lives.
•People develop self-determination capacity.
•People contribute to their communities
Community Settings
•People live in communities.
•People achieve personal goals and outcomes in communities.
•People have responsibilities in the community.
Social Capital
•Communities promoted social capital for all people.
•The organization and civic networks enhanced Community Lifesm for all people
Community Partnerships
•The organization defines and exercises its responsibility in building social capital.
•The organization enables people to participate in community development activities.
•The organization involves community partners in the affairs of the organization.
•The organization’s members assume leadership positions in community activities.
•The organization recruits community representatives for leadership positions.
Shared Leadership
•All people demonstrate leadership and responsibility.
•Organizational participants contribute to the goals and priorities of the organization.
Continuous Learning
•Organizational participants develop relevant skills and knowledge.
•Organizational participants contribute to networks of trust and reciprocity.
Open Communication
•The organization promotes communication between and among staff, families and people supported.
•The organization communicates its mission, priorities and management plan.
•The organization has procedures for soliciting input from people served, supporters and the community.
•The organization demonstrates how learning causes change.
Continuous Improvement
•The organization determines that its supports are meaningful to each person.
•The organization integrates learning into practices that support outcomes.
•The organization does ongoing quality improvement.
•Quality improvement includes the collection and analysis of data related to quality assurance, quality improvement and quality of Community Life.
Continuous Improvement
•The organization determines that its supports are meaningful to each person.
•The organization integrates learning into practices that support outcomes.
•The organization does ongoing quality improvement.
•Quality improvement includes the collection and analysis of data related to quality assurance, quality improvement and quality of Community Life.
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Training Module |
Related Personal Outcome(s) |
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Confidentiality, Accountability, Prevention of Abuse and Neglect |
People are safe.
People are respected.
People are treated fairly.
People are free from abuse/neglect.
People have the best possible health.
People experience continuity & security. |
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Sign and Symptoms of Illness and Seizures |
People are safe.
People have the best possible health.
People are free from abuse & neglect.
People experience continuity & security. |
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Recognizing and Preventing Suicidal Behavior |
People are safe.
People have the best possible health.
People are free from abuse & neglect.
People experience continuity & security. |
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OSHA guidelines |
People are safe.
People have the best possible health.
People experience continuity & security. |
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Fire Safety/ Disaster Preparedness |
People are safe.
People experience continuity & security. |
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PRA (or PCM or Mandt or CPI) |
People are safe.
People are respected.
People are treated fairly.
People are free from abuse & neglect.
People experience continuity & security.
(All AUTONOMY and IDENTITY outcomes) |
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First Aid/CPR |
People are safe.
People have the best possible health.
People are free from abuse & neglect.
People experience continuity & security. |
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Lifting, Transfers and Transit Safety |
People are safe.
People have the best possible health.
People are free from abuse & neglect.
People experience continuity & security. |
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OJT checklist |
People are safe.
People are respected.
People are treated fairly.
People exercise rights.
People have the best possible health.
People are free from abuse & neglect.
People experience continuity & security. |
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Understanding Disability |
All Personal Outcomes |
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Empowering Individuals |
All Personal Outcomes |
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Defensive Driving |
People are safe.
People experience continuity & security. |
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Applied Positive Programming or The Carolina Curricululm on Positive Behavior Support |
People are respected.
People are treated fairly.
People are free from abuse & neglect.
People experience continuity & security.
All of IDENTITY and AUTONOMY outcomes. |
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Person-centered Planning:
“Hear My Voice, Honor My Choice” |
All Personal Outcomes. |
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Consumer Satisfaction Measures
Personal outcome measures (see the previous section) are often founded on goals that the individual has set for themselves in conjunction with their family and their “circle of support”. They are thought about and discussed, hopefully weighed against alternative goals and decided upon. To this degree they are objective and “matters of the head”.
On the other hand, measures of consumer satisfaction have a larger affective component; satisfaction is a “matter of the heart”. It is very possible for a consumer to have met all of his personal outcome measures, but still feel dissatisfied with his life or the services and supports that he is receiving. Thus, measures of consumer satisfaction must go hand in hand with personal outcome measures in order for an agency to be truly consumer-focused and driven.
Consumer satisfaction surveys are conducted periodically with consumers, families and other stakeholders. DDSN and service providers use this information to improve services and make them more responsive to consumers’ needs and wishes.
Organizations:
The Council
100 West Road, Suite 406
Towson, MD 21204
(410) 583-0060
Visit this web site: www.thecouncil.org
The National Center on Outcomes Resources
100 West Road, Suite 406
Towson, MD 21204
(410) 583-0060
Visit this web site: www.ncor.org
QualityMall.org
Go "shopping" for innovative ideas related to person-centered approaches that enhance the quality of life for people with disabilities.
Visit this web site: www.qualitymall.org
Publications:
Managing the Non-Profit Organization, by Peter F. Drucker. Published by Harper Collins Publishers, 1990.
Focus Groups-A Practical Guide for Applied Research, by Richard A. Krueger. Published by Sage Publications, Inc., 1994.
The 3 Keys to Empowerment, by Ken Blanchard, John P. Carlos, Alan Randolph. Published by Berrett-Koehler Publishers, Inc., 1999.
A Complaint is a Gift, by Janelle Barlow, Claus Moller. Published by Berrett-Koehler Publisher, Inc., 1996.
High Performance Nonprofit Organizations, Managing Upstream for Greater Impact, by Christine W. Letts, William P. Ryan, Allen Grossman. Published by John Wiley & Sons, Inc., 1999.
Quality Performance in Human Services, by James F. Gardner, Sylvia Nudler. Published by Paul H. Brooks Publishing Co., Inc., 1999.
What Every Manager Should Know About Training, by Robert F. Mager. Published by The Center for Effective Performance, Inc., 1992.
The ASTD Training & Development Handbook, by Robert L. Craig. Published by McGraw-Hill Co., Inc., 1987.
SC Disabilities Collaborative Resource Center Library
8301 Farrow Road
Columbia, SC 29203
(803) 935-5278
The American Society for Training & Development
(800) 628-2783
Visit this web site: www.astd.org
Library:
The Center for Disability Resources Library is located at the University of South Carolina School of Medicine's Library, which is on Garners Ferry Road in Columbia, SC.
The library is a collaborative effort between BabyNet/SCDHEC, SCDDSN, The Center for Disability Resources and the USC School of Medicine. The CDR Library holds a collection of books, videos, and audiotapes regarding disability-related issues across the life span.
Additional information about the library is available at http://uscm.med.sc.edu/CDR/index.htm
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