New Priorities for Service Interactions
The use of outcomes in services represents a fundamental shift in how we think and do business in the human service world -- not just new standards for quality. As we begin to think about implementation, we recognize that some of our old service assumptions will not work. In fact, some of these beliefs will work to keep us from supporting the outcomes that we want to see people attain. Below is the beginning of a new list of priorities that will enable staff to work with people toward outcomes.
The person sets the agenda (not the professional/experts)
Traditional services have relied on professional assessment and judgment as the primary resources to identify individual needs for services. People served were invited to meetings to hear what had been identified as important for them. At best, the person's role was limited to one voice among the many. Outcomes for people require just the opposite. The person sets the priorities and the professionals listen. Professional expertise is used as a tool to enable people to move toward their personal goals, not to set those goals for people.
It's more important to be respectful and responsive than to always do things the "right" way
Professional standards were intended to assist practitioners to find the right services for people. Specific process and procedures were followed in the belief that these would lead to positive outcomes for the person. Unfortunately, this quest for "correctness" in process has often left little room or time for real individualization. We are now finding that the most important characteristic of good service is to listen to the person and to respect the person's perspective and experience. Seeking to understand the person before making recommendations for services is the only way the service provider can make sure that services addresses what is most important for the person.
Listening is an important skill and activity
Our ability to communicate with and learn from each person served will be very important if the "quality" of services is based on responsiveness to people. Service staff must not only be willing to hear suggestions from the person, but actively seek information from the person about personal needs and services. This kind of interaction and active listening is a skill. The interpersonal skills needed for establishing relationships with people will be as important as professional skills. Training and support for staff must emphasize this new priority. We must also learn to value time spent with the person engaged in active exchange as much as other kinds of activities.
Use guidelines as supports (not gospel)
Although standards for practice and professional guidelines are important resources, they do not contain the answers for people. The important "answers" are known by the person and must be discovered through interaction and experience. Since change is one of primary products of human services, it makes sense that our processes will need to be flexible. A constant flow of information about the person, and his or her interests, preferences and circumstances is essential to make sure that service process continues to meet the person's requirements. Service staff must be ready to change any thing at any time, revising plans and actions based on new information from the person. Adherence to practices that do not serve the person, just because they are "the professional standard," will no longer be acceptable.
Real change requires that we re-examine all of our basic assumptions about people and practice that direct and guide our practices. Many of these assumptions may be well intended, but not productive. If the person is truly the most important variable in the service process, we must expect that it is our job and responsibility to design services around each person's needs. Quality in services for people is reflected by the commitment to removing whatever barriers prevent the person from experiencing success.