History
uSPEQ® GREW OUT OF WORK ON PERFORMANCE INDICATORS
VOICES OF PERSONS SERVED, PROVIDERS, AND PAYERS GUIDED DEVELOPMENT
uSPEQ arose from a decade of extensive work on performance indicators conducted by CARF International, an independent accreditor of human service providers. In developing uSPEQ, CARF was guided by the voices of organizations; payers; and, most importantly, persons served by human service providers.
1996-1998: CARF convened two national leadership panels, a performance indicators working conference and an advisory council. Each venue involved stakeholders from across the fields and program areas CARF accredits. Although the objectives of each of these meetings and council varied, CARF's overall goal was to seek advice on developing performance indicators to be applied in the human service field as part of CARF's activities to carry out its strategic outcomes initiative. These activities culminated in the publication of the Performance Indicators for Rehabilitation Programs 
(PDF).
CARF developed and first administered in private industry the original employee survey upon which the uSPEQ Employee Climate Survey is based.
1999-2000: CARF conducted consumer forums in Washington, D.C., and Boston in collaboration with Boston University's Center for Psychiatric Rehabilitation. Findings from these forums led to the identification of indicators highlighted as most important by consumers. The "draft keepers," as they came to be known with CARF stakeholders, represented the culling of candidate indicators to a more compact set of indicators that now revealed striking commonalities across interest groups of many consumers, providers, payers, and other stakeholders.
2002: CARF renewed its performance indicators efforts, beginning with a review of developments and literature in the field. In this phase, CARF aligned its indicators with major national and international conceptual frameworks, including Healthy People 2010, Disability and Secondary Conditions, Chapter 6; World Health Organization/International Classification of Functioning, Disability and Health; Institute of Medicine quality framework domains; CARF business practices standards; and CARF's ends policies. A crosswalk between CARF's performance indicators and performance measurement vendors and systems was also completed.
2003: A performance indicators workgroup composed of consumers, experts, and researchers met to review and refine the work accomplished the previous year. Following this meeting, two rounds of consensus-developing input, using a modified Delphi process, were conducted to recommend a set of potential subjective items to create a crosscutting consumer questionnaire. The ensuing draft of the consumer questionnaire contained both demographic questions and survey items on which the consumer would rate his or her experience with services received and the outcomes he or she attained.
2004-2005: Providers in the human service field participated in pilot testing of the draft of the consumer questionnaire, by then named uSPEQ. The pilot results were compiled in the uSPEQ Consumer Experience Survey development and technical report .
2006: CARF introduced subscriptions to a full range of uSPEQ Consumer Experience Survey data services.
2006-2007: Following nine consecutive years of administration with only minor revisions, the content of the uSPEQ Employee Climate Survey was refined through extensive literature review and research on factors associated with and components of employee satisfaction. A variety of organizations participated in a pilot test of the survey. The pilot results were compiled in the uSPEQ Employee Climate Survey development and technical report .
2007: CARF introduced subscriptions to a full range of uSPEQ Employee Climate Survey data services.
2008: uSPEQ Consumer Experience Survey underwent another round of data analysis in an effort to reduce the length of the Tier 1 universal items and, at the same time, to validate the psychometric properties of the refined questionnaire. Both qualitative and quantitative analyses were conducted, resulting in uSPEQ 2.0. The new version features a refined set of 20 universal items and an enriched set of 85 optional items presented in modules corresponding to service fields. The results were compiled in the uSPEQ Consumer Experience Survey development and technical report .
FUTURE uSPEQ OPPORTUNITIES
EXTERNAL BENCHMARKING
External benchmarks can be used to compare organizational results to the results of other organizations in the same industry or region. The ability to understand how one organization's results compare to those of others can help in identifying areas for performance improvement and marketing efforts. Analyzing differences between organizations, or over time, requires a thorough understanding of the data and sufficient data to ensure meaningful sample sizes. Therefore, research will continue with uSPEQ data as its use grows. uSPEQ anticipates that sufficient data will be available for external benchmarking in the near future.
ONGOING RESEARCH AND DEVELOPMENT
Ongoing data analysis will continue to evaluate, and if needed, refine existing questionnaires. uSPEQ also has a long-range research agenda to develop additional stakeholder surveys to assist organizations in their quality and performance improvement efforts.