Definitions of Innovative and Exemplary Respite Services
Best-practice, and evidence-based practice, are considered to be the gold standard for health, education, therapeutic and social services. These practices and standards help assure excellence and accountability to those we serve.
While we all strive to implement best- and evidence-based practices, these practices rely in part on funding sufficient to support high standards of care, and research and evaluation that establish effectiveness and worth. Although caregivers often site respite services as their highest priority, sufficient and sustained funding remain challenging to individual respite services and systems.
Despite this challenge, individual respite services across the country create, refine and sustain exemplary and innovative practices. Documenting the successes of these services increases the likelihood that others will recognize the meaning of respite in human terms, and the importance and worth of respite. As we grow in our understanding of what exactly makes respite services exemplary, we can replicate them, in whole or in part, increasing the likelihood that respite services come closer to our aspirations for excellence. Any one program’s success is increased manifold when we all learn from that success and understand how to repeat it for the benefit of caregivers and care recipients.
What do the terms Exemplary and Innovative mean? ARCH defines these terms, and recognizes respite services, based upon seven characteristics.
1. Use of Evidence-based or Evidence-informed Approaches. Exemplary respite services are supported by research or evaluation evidence, have shown benefit(s) to family caregivers, and may also have shown benefits to care recipients, families and society. Innovative respite services document or plan to document at least one family caregiver outcome and create a novel approach to respite, or approaches adapted for a specific community or population.
2. A Written Plan with Goals and Objectives. Exemplary and innovative services specify goals and objectives that are observable and measurable. Exemplary services set performance targets based upon established evidence. Innovative services set performance targets that may be modified based upon data collected during day-to-day practice.
3. A Program or Service Manual or Guide. Exemplary and innovative programs or services follow written policies and procedures in their day-to-day activities that allow them to monitor fidelity and minimize drift from their stated goals and objectives. Exemplary services guides are sufficiently detailed to allow replication. Innovative services may not yet have developed a formal manual, but have written protocols or checklist sufficient to guide essential activities.
4. Person- and Family-Centered Services. Exemplary and innovative programs or services document culturally sensitive and responsive procedures and assure that caregivers guide their own choices regarding respite services, and that the respite services are meaningful for the care recipient. Exemplary and innovative services assure that family caregivers and/or care recipients have purposeful roles on the program’s advisory board or in some other advisory capacity.
5. A Professional Development Plan. Exemplary and innovative services ensure that volunteers and paid personnel are trained, coached and supported so that they can competently and confidently follow policies, protocols, and procedures required for the respite services they offer. Exemplary and innovative services carefully screen volunteers and paid staff to ensure the highest safety standards for families.
6. A Plan for Collecting and Evaluating Data. Exemplary services have a performance measurement plan for measuring consumer satisfaction, service implementation/model fidelity, and at least one participant-focused outcome, and they regularly collect data for each of these. Innovative services, at a minimum, have plans to collect at least one participant-focused outcome and regularly monitor their program to make sure services are implemented according to guidelines and
protocols. In addition, Exemplary services also regularly review data, use data to make informed decisions about programs and services, and share data with staff, consumers and stakeholders. Exemplary services also conduct a formal internal or external evaluation documenting outcomes and effects.
7. Demonstrate sustainability. All respite services under consideration have been in existence for at least three years. To be considered innovative or exemplary, services have intentionally planned to ensure sustainability.
The services selected by ARCH for recognition may demonstrate practices that are both Innovative and Exemplary if they meet all of the criteria above.
Services identified as Innovative use a delivery approach that is novel and/or unique to a specific community or population for whom it is intended, and meet most criteria as defined in the ARCH framework, but have not yet implemented a rigorous evaluation of their service that allows replication of their approach.
Services may also be recognized as Rising Stars. Rising Stars have demonstrated a person and family-centered approach, but have not yet met all criteria for Innovative or Exemplary practice. They offer respite services in ways that are readily recognizable as worthwhile, and that we hope will be documented and evaluated in the future to demonstrate their merit and allow replication by others.
It is expected that all recognized services will have the potential to contribute to the knowledge base that will guide expansion and replication of much needed quality respite services.
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