How a quality framework can support EGL system change
An important part of the EGL approach is that, as well as building new ways of doing things, disabled people have ways to check that it is working well for individuals, families and communities (i.e. check quality and outcomes). Disabled people have contributed to a number of seminal reports that have made recommendations about an EGL-based approach to quality.
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The use of developmental evaluation
Many reports have called for a comprehensive developmental evaluation process: development of disability standards, with appropriate outcomes-focused evaluation processes; ensuring that quality-of-life is measured and valued by giving people with disabilities and their families a significant role in the monitoring process.
Giving disabled people a voice
Voice mechanisms help build the capacity of disabled people and enable them to have self-determination and more control of their lives. Independent voice mechanisms can help disabled people share their experiences and raise issues with current support arrangements. Specific regard should be given to ways for tāngata whaikaha Māori and whānau to have their voice heard. Crucially, there must be processes to act on what is heard.
Driving quality practice by focusing on what works
The Putting People First report said that the Ministry should set out what quality practice and outcomes look like and monitor against it. Best practice should be actively supported including showcasing examples of good quality practice (Van Eden, 2013, p. 3). This includes peer review, developing and sharing new ideas, and providers working co-operatively with like-minded organisations to jointly develop and share resources, such as staff training.
Better complaints and issue resolution processes that influence change
The Social Services Committee (2008) said that complaints processes should be made more accessible, including a pathway for verbal complaints. Putting People First (Van Eden, 2013) emphasised the need to ensure the safety of disabled people after laying a complaint. That report also called for timely and independent investigations of significant complaints using experts.
Improved data collection and outcomes measurement and reporting
Contract performance monitoring reports should be focused on quality-of-life outcomes (Van Eden, 2013). Accountability would be promoted by making the evaluation of services readily available to the public (Social Services Committee, 2008). Drivers of exceptional performance should be identified, and key performance indicators designed around this to support positive behaviours and outcomes (Van Eden, 2013).
Safeguarding is paramount
Putting People First (Van Eden, 2013) emphasised that there must be a policy of zero tolerance of the abuse of disabled people. It was seen that there is a need to ensure the legislation covering disabled people provides the necessary protection to keep disabled people safe from serious harm.
Quality measurement
Measuring the quality of services can be a difficult endeavour. There often isn't a universally accepted definition of what constitutes quality, how it should be measured, or how this process can help providers to make improvements. Emphasis should be placed on the impact that supports have on quality of life, supplemented by indicators that evaluate the structures and processes of services and providers.
There exists a body of literature on quality-of-life concepts and measurement. In New Zealand, developmental evaluation and quality-of-life survey tools have been co-developed with disabled people and whānau, grounded in EGL principles and relevant literature.