Involving Families and Staff in Service Improvement

This study was designed to improve an important service for severely mentally retarded adolescents and adults. The overall objective was to investigate the effect on client and staff behavior of implementing procedures designed to achieve change in three priority service areas selected by the families and staff. The experimental design was a three phase time series design. In the final phase, three procedures designed to achieve change in the selected areas were introduced sequentially. The service areas selected were staff organization, staff-family communication and clients' recreational activities. The setting supervisors monitored staff use of the procedures by means of a structured checklist and gave staff direct feedback on their performance. Checklists used by the researchers revealed consistent use of the procedures by staff. Observational measures showed marked changes in the behavior of both staff and their clients. Comparisons of interviews with staff and families conducted prior to and following the interventions revealed general satisfaction with changes achieved and increased staff emphasis on client teaching. This study demonstrated the feasibility and desirability of involving staff and families in making plans for service improvement.