PAULA MCELWEE: So let's 
talk a little bit about 
quality and what defines

quality and how we 
are going to approach 
that as we go along.

All right.

So the first question is why 
are we doing this right now?

Some of this comes from my interim 
experience, for my part of this

anyway, as we talked as a team 
about the topic that we wanted

to do and how we wanted 
to approach it,

there has been a lot of conversation 
around compliance, and most of us,

I think, are aware that there have 
been increased numbers of compliance

visits from our the 
funder to the centers.

There has been a lot of 
attention on what the rules are,

how to do those rules, and some 
days I feel like we are a little bit being

high-jacked by the compliance piece and 
so much attention to those rules

that we don't stop and ask ourselves 
what does quality mean to our center

in our community to the 
people that we serve.

Those external requirements 
do have to be met.

We don't really have 
a choice about that,

but how can we make what we 
do in compliance meaningful

to us in the bigger quality picture?

And that's what we want to 
talk about while we are here.

Our mission -- your each center 
probably has a mission statement

and that mission and the dreams 
that the disability community,

the board that the -- the folks 
that your center have for services

in your area were for the changes 
in the community in your area 
that are going to come.

Those are foundational to who you are 
and compliance is one piece of that,

but only one piece, and if we 
look at our mission and dreams

in addition to that, it can take 
us to some very exciting places.

That's where we started and 
where we want to go, right?

We don't want to lose track of 
that mission while we are doing 
other things.

Darrell Jones who was writing 
up here a minute ago does 
a CIL funding and development

blog and there is a link at 
the end of this presentation and

if you aren't familiar with that, 
you can subscribe to that blog,

great articles that can come 
across your desk, around 
the issue for additional

funding for centers, but this quote 
really struck me when I read the 
blog the last -- last month's blog.

When considering moving into  
an area of earned income – 
that was the topic.

One of the first questions the 
center for independent living 
will probably ask itself is

will accepting this money 
support or derail our mission.

Good question, right?

As we look at whatever we do, 
is it going to support or 
derail our mission?

And that same question 
is fundamental to any 
kind of choice that you are

going to make about direction, 
and within your center,

you decide what's going to 
help us to support our mission.

It's a fundamental thing that has 
to underlie and support everything

else we do, and if we can't hold 
on to that mission, we have, then,

an issue where our -- we lose and 
can actually drift from that mission.

So mission drift was the term that 
Darrell used in the article and

I thought that was really helpful 
to think about, because we have

seen centers that we 
know have drifted, right?

I bet you we know somebody 
who -- that we are kind of

wondering about them anyway, 
because they seem to have

gone in a completely 
different direction.

When we look at quality, we want to ask 
ourselves a series of questions

and we will be framing questions 
different ways throughout the 
next few days.

Are we doing the work 
of the center well?

What is the work of the center?

Are we doing it efficiently?

In other words, are we 
using our resources well?

Are we doing the right things?

Because there is nothing so 
useless as doing efficiently that which 
should not be done at all.

So you can be as efficient as you want 
but if you are doing something

that's not on track, 
it's drifted, 
it is not helpful.

Are we doing what is important 
to our constituents, our consumers,

and are we doing what is 
truly transformational?

I want to think about each one of these 
as we go through the topics

today because we do want to 
transform our centers into

ever more effective entities 
in our communities.

We consider ourselves 
agents of change.

Consider ourselves a movement and 
unless we can transform things that

are not as they should be, 
we are not completely

fulfilling that part of our mission.

Well, there are several definitions, 
let's say, of quality.

These are some that we picked up 
and we want to look at briefly.

And then on your table you 
will find one of these definitions 
on a piece of paper.

I have extras if you don't but 
there should be a piece of paper.

That's the one you get to talk 
about in your group in a minute.

The first one we have 
is fitness for use.

That means that the 
product or the service 
does what it's intended to do.

Poor quality of a product or 
service cost the users if it doesn't 
do what it's intended to do.

So one of the common definitions 
of quality is that a product or a

service is of quality if it 
does what it's supposed to do.

So IL skills training, something 
that we provide all of us, 
is supposed to do what?

We will have to define 
how but go ahead --

AUDIENCE MEMBER: It is 
supposed to help the person

become independent and it's not 
necessarily functional life skills.

It's decision making skills and if the 
person can't make a decision,

one of the first thing we do is to 
get them into an experience

so they can learn how to 
make decisions.

PAULA MCELWEE: Now you 
heard -- that is an excellent 
statement, thank you.

You heard how this center is defining 
independent living skills training in

a way that they can measure 
whether or not it's going to

be doing what 
they wanted it to do.

Did you hear some of that?

It will be in the transcript 
when we post the video.

We can pick that up again.

Excellent.

So we want to make sure that we 
are doing what -- the things we say 
we will do, that we intend to do.

We also want to meet the expectations 
of our customers and these two things 
aren't always the same.

You heard a little conversation 
over here with the question that was

offered around what the 
customer wants or the 
consumer wants specific

things that we might give to them, food 
and housing and those kinds

of things, so there is sometimes 
tension between these different

definitions that we will have to 
sort out but quality is satisfying

the customer in this 
second definition.

The customer, then, 
defines the quality.

And the customer, then, 
looks at whatever you 
provided in a product

or service and says yes or no.

Does it meet their standard 
or their individual need?

And that will be how they 
would determine quality.

A third definition is quality is 
exceeding the customer expectations.

Now, a lot of us really like this 
definition but the others are also very 
practical for us, aren't they?

I mean, each of these has a 
different approach a little better.

So quality is the extent to which 
the customers or users believe the

product or service surpasses 
what they were expecting.

So quality is delighting 
the customer.

They are so pleased with what's 
happening that it -- they are excited.

That's much bigger than meeting a 
set of compliance indicators, isn't it?

How are we getting past just 
satisfaction to real delight in what's 
happening at your center.

And then the fourth definition 
we have here is how companies,

products, and services 
compare to competitors.

Now, we often compare ourselves
because we sometimes are the only

center in our community, we compare 
ourselves to the medical model,

so we say on the independent living 
side, we give people a lot of choice

and respect and expectation that 
they take control of their lives.

On the medical model side, 
there's a lot of doctors making

decisions for you and a lot less 
respect for what your abilities are.

So that's often the 
comparison we make.

There may be other comparisons, 
but how do we compare to either what

you've done in the past or what 
other entities that are different

from you are doing, 
and how does that work out.

And then compliance is either a state 
of being in accordance with those

guidelines and specifications or 
legislation or we're going to go

through some of the compliance 
indicators in a little bit.

The process of becoming 
compliant with a set of rules.

And that's very different.

Doesn't it feel completely 
different, when you read that one,

as opposed to reading 
about exceeding expectations?

It's like two different -- 
completely different things, 
and that's what we want to do.

So we are also going 
to talk about outcomes, 
and not a lot at this moment.

But outcomes are something that 
follows as a result to a consequence

of something that you do, 
and outcomes are a way 
to measure quality.

If you set an outcome, you make a 
decision about what you want your

outcome to be, and then you can 
measure it, it gives you a way to 
lead you through.

So these are all terms we'll be 
talking about as we go through 
our presentation today.