State Performance IndicatorsWhy This Is Important
The increasing emphasis on outcomes and performance assessment is more than merely a change in measurement approaches. It represents a change in the assumptions about what "quality" is and reflects a larger shift in the field -- specifically from program-oriented, formulaic models of care to individually tailored supports based on individual choices and preferences. As a result, the adoption of performance indicators as a quality assurance technique is both a consequence of the change in expectations as well as a method for maintaining a focus on person-centered outcomes. As supports become more individualized, strict input and process measures become problematic since prescriptive standards constrain the flexibility and creativity needed to individually tailor supports to people's unique capabilities and preferences. Further, the growth of continuous quality improvement and total quality management initiatives have contributed to the prominence of indicators linked to observable performance.State performance indicators are a logical consequence of the increasing emphasis on outcomes, concerns about the consistency of performance with state missions, and an intensified commitment to ensure that services and supports are accountable to people with developmental disabilities, their families, and the taxpayer.The development of indicators of system performance is an important first step in establishing a durable and robust method of tracking the progress toward change and improvement in systems of support for people with developmental disabilities and their families. To be successful, the indicators should be continually reviewed to determine whether they are:* Valid, reliable reflections of the aspects of change that are valued by the public agency and its constituency;* Cost effective insofar as the burden of data collection and analysis;* Sensitive to changes in the system.