So you have got the individual and his team’s consensus on what goals or skills area to provide support. Now to make sure the goals are set up for success, you need to know how best to execute the plan to ensure a quality outcome.
Know your priorities for quality assessment of service outcomes. Are your priorities on the competencies of your staff or are your priorities on the quality outcomes to individual service users? Did you say both? Yes, correct! But do you intend to assess both together? To put it more bluntly, are you concerned about the qualification of the direct support professional (DSP) who implements the goals with the individual or you are more concerned about the outcomes or impact the individual benefits from the support?
What you need to do is to assess your staff separately based on the expectations and appropriate required and best practice training they received, and evaluate the outcome or impact of support on the service recipients.
When you decide to evaluate the impact or outcomes of the implementation of the goals, the following 8-step plan to help you plan and understand exactly how to achieve and measure a quality service result:
1. Identify Quality Component and Subcomponents Of The Goal:
To assess whether the goals are being implemented properly, you will need to break them down into achievable and/or measurable steps or components presented through the actions that staff take or facilitation with the individual. Consider the following example:
Remember, each task or staff action can be broken down into simpler ones to reflect the individual's level of functioning or involvement. This method is applicable to any goal regardless of the severity of challenges that the individual faces or types of service the person receives.
2. Set Quality Targets
To set your Quality Targets, think about what you would want other members of the team to know about the individual's relationship (i.e. accomplishment or challenges) with the planned goals during the course of implementation. In addition to feedback from self-reporting individuals, think about how the information from this section will be beneficial.
Be sure that the level of quality is acceptable to the individual and that it falls within the mission of your organization. Be sure to include the impact of the service on the individual’s physical and/or emotional wellbeing. Obtain a rounded view by involving the primary support staff members and the individual, where appropriate, so as to sync everyone's expectations of what quality looks like for different deliverables/components. Set Quality Targets for all the current goals that the individual is working on.
3. Define Quality Measures
Having identified Quality Components, and Setting the Quality Target, you are now ready to set a clear expectation or definition of how quality will look like relevant to a given target. At this point, it shouldn't be difficult because you and your team already know how quality will be judged. By defining quality, you will be able to know whether or not the individual has accomplished a target.
Use a simple 'yes/no' tool to indicate whether the individual acted upon the support if an action was required on the part of the individual. You may also choose to use a scale, for example '1 for ATTEMPTED, 2 for REFUSED, 3 for INVOLVED' and so on.
Document the measures for each Quality Target. It's important to do this regularly from the beginning of the goal whose outcome or impact is being measured. Regularly documenting the measure of each quality target is also a good way for the relevant team members to know how their performance will be assessed by the end. Create a weekly table that you can use to check the Quality Measures on a daily basis.
NB: Frame the definition or expectation of Quality Measure into questions to make it easier to answer or assessed. The Stakeholder’s Question is the direct inquiry into the individual’s own personal response. If the individual cannot verbally respond to stakeholder’s questions, assess and obtain responses in ways that the individual usually communicates.
4. Set a Schedule
Do not wait up until the next annual or semiannual team meeting before you begin compiling updates about the status of the goal or support provided since the team last meeting.
Obviously, there will be certain steps that will need to be completed toward reaching a Quality Target of the goal and toward the point where you will start evaluating the impact of the support upon the individual.
Plan to tally the daily inputs on a weekly basis. At the end of at least a four-week period, conduct a review of the tallies for the last four-week period. You need to tally the responses or reactions of the individual to the support provided which are framed as questions in Table 3.
Ensure that the necessary resources are available to facilitate the implementation of the goals. Those resources can include the appropriate and up-to-date training, materials, and other supports.
You may decide after a few months of implementation that the team is reconvened with the individual to rework or shift the focus of the goal if you find that there are other prerequisites to the goals that need to be addressed before the goal can be meaningfully implemented.
Remember that you need to put in place everything required to deliver a quality result as well as evidence that would prove that you've done so.
5. Take Action
Allow a staff member to take ownership of ensuring quality by being a co-participant with the individual in the implementation of the planned goals. Ensure that the DSP understands every step in the implementation and that he/she is responsible for quality at every step of the way.
Ensure that the tools being used to outline the tasks and for measuring the result reflects the unique components of the goals being implemented.
6. Quantify Quality
You must be excited at this point because now you are at the juncture where you can measure quality for the first time based on the system you have put in place. Try doing this every 60 days from the start of implementation or as of the date of the last evaluation whichever is earlier. Consider the example below:
Be careful not to hastily change a goal based on new challenges or progress because situations could change the balance given the fluid nature of direct support. However, the more regularly you do the 60 days evaluation, the more you will know what component is being completed or which one poses a challenge, and this will also give you more time to fix any problems.
Additionally, measuring quality early and often will give the individual and the team confidence about the status of implementation.
As soon as there are progress results to share, communicate them to the individual, the primary staff and other members of the team. This is necessary because this will acknowledge the individual’s progress as well as the support and facilitation that the staff and other team had put into making the progress possible. In the same vein, if there are components of the goals that still require more work in order to bring the individual closer to the Quality Targets, make sure that the team, including the individual, knows about that as well.
8. Update & Re-evaluation
Update the individual’s plan through his/her informed inputs. Include any additional work that needs to be done in order to retest deliverable components of the individual’s support plan. As the team goes through this more frequently, it will discover other ways to improve the quality of support to the individual.
Remain consistent. Repeat the process. Evaluate early and regularly for better understanding and guide to improving quality and impact of support.