A Proposed Framework for an Integrated Process of Improving Quality of Life

The need for quality of life, both as a concept and as a measure, to be applied to policy and practice has been noted in the disability literature for several years. In 2012, Schalock and Verdugo introduced a conceptual model to help service organizations evaluate if congruence exists among their systems, policies, and practices and, if misalignments exist, to make changes through policy and systems change. Their model focuses on two levels, system-level processes and organization-level practices, at three consecutive stages of use: inputs, throughputs, and outputs. In this article, the authors extend the work of Schalock and Verdugo by adding a third level of application, individual- and family-level living, and propose the inclusion of outcomes as a fourth stage of use representing a consequence of outputs. We recognize the dynamic interaction among all components of the conceptual framework and, like Schalock and Verdugo, argue for alignment both vertically (system, organization, and individual and family living levels) and horizontally (inputs, throughputs, outputs, and outcomes) within our revised conceptual framework. Based on this, the authors propose that quality of life outcomes (the ongoing effects of outputs) should be an ultimate focus of service organizations and policy development if quality of life is to be enhanced for individuals with intellectual and developmental disabilities and their families.