Outcomes, objectives, goals, indicators, measures, targets…. These are words that are often confused and considered to be overly complex. Sometimes we get lost in the content and might prefer to discard them entirely!

Why are they important?  Outcomes and objectives help individuals and organizations stay focused on that compelling vision of where they are trying to get to.  They provide a manageable structure of looking at the big picture vision as well as the small steps forward and the markers for celebration. For organizations and systems of care, they also provide a way of evaluating how well care and support services are meeting people’s needs.
What are these terms?

Objectives or goals are intended results or the impact of learning, programs, or activities, etc.

Outcomes are achieved results or impact of what was learned or experienced.

The outcome is best, and most clear, when stated as if it has already been achieved. It then serves as a snapshot of a desired future state.

 Indicator or measure: is a visible or tangible target lets us all know when people are approaching their desired outcome. They are steps, or ‘indicators’  along the way

Questions to help us sort this out might include:

What are we trying to achieve? What will be the end result or impact when all efforts on this are finished? – the outcome

How will we know when we are making adequate progress? – these become measures or indicators

What steps will we take to achieve our desired outcome? – objectives or goals

Stephen Covey advocated that we ‘begin with the end in mind.’  In this spirit it is helpful to start with the overarching desired outcome first, followed by selecting measures (indicators) of progress, and finally determining strategies or goals/objectives that make sense.

Of course, to do this well, we must know what is important to and for each person and ensure that they have choice and control over identifying outcomes and indicators that are make sense and are meaningful to them.

A System View

The development of outcomes and indicators at the organizational and system levels are also an important part of establishing a reliable method of tracking progress toward change and improvement in systems of support for people with intellectual and developmental disabilities (ID/DD) and their families.

In an organizational context, personal outcomes assess life experiences of people who receive care and support in order to measure how well the services in place are meeting the person’s needs.

In the US, two frameworks that are referenced broadly when developing outcomes are the Council on Quality and Leadership (CQL) and the National Core Indicators (NCI). CQL has developed 21 Personal Outcome Measures, as a result of interviewing thousands of people with intellectual and developmental disabilities. These can be individualized and are organized around three factors:

My Self: Who I am as a result of my unique heredity, life experiences and decisions.

My World: Where I work, live, socialize, belong or connect.

My Dreams: How I want my life (self and world) to be.

You can learn more about the quality of life personal outcomes developed by CQL at their website http://www.thecouncil.org/Personal_Outcome_Measures.aspx

and by reading this document http://www.thecouncil.org/assets/0/86/201/0c471dea-633c-4539-85a7-aa048e68ac0a.pdf

In many states, and now in California, the National Core Indicators are helping to guide understanding and practice around quality of life outcomes.

NCI uses a framework of individual outcomes in five broad areas:

Relationships:   People have friends and relationships.

Self-Determination:  People have authority and are supported to direct and manage their own services.

Choice and Decision-Making:  People make choices about their lives and are actively engaged in planning their services and supports.

Community Inclusion: People have support to participate in everyday community activities.

Work:  People have support to find and maintain community integrated employment.

To learn more about the National Core Indicators visit http://www.nationalcoreindicators.org/indicators/- Individual Outcomes

How does this all work together?

If we put it all together, it doesn’t have to be overly complex.  It can, in fact be quite simple. Here I’ve included two examples of how outcomes, indicators, and objectives can be used together to clarify support for Ken. I’ve also included a column that shows how the same process is used on an organizational or system level.  After the outcomes, indicators and goals are determined, the discussion would continue to identify the services, supports or strategies to be put into place to support the accomplishment of the goal.

Individual Outcomes System/Service Delivery Outcomes
Ken makes choices about his life and is actively engaged in planning his services and supports.  People make choices about their everyday lives, including: housing, roommates, daily routines, jobs, support staff or providers, what to spend money on, and social activities.
Indicators System Indicators
Ken reports that he chooses his own staff.  The proportion of people who make choices about their everyday lives, including: housing, roommates, daily routines, jobs, support staff or providers, what to spend money on, and social activities.
Individual Goals Organization/System Goals
Ken will complete training in using person centered profiles for staff matching, recruitment and selection.  Deliver training on the application of one page profiles for staff selection to people with individual budgets in three counties to support them in choosing their own staff.

 

Individual Outcomes System/Service Delivery Outcomes
Ken has friends and meaningful relationships. People have friends and meaningful relationships.
Indicators System Indicators
Ken reports that he gets to help others.  The proportion of people who report that they get to help others.
Individual Goals Organization/System Goals
Ken will participate in a volunteer service twice each week. Develop resources for volunteerism as an alternative to traditional day programs.

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