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  • ASPIRE to Excellence® framework for quality improvement

    ASPIRE to Excellence® represents a practical approach to achieving optimal outcomes for providers and the persons they serve.

    For more than 40 years, the CARF seal has been the hallmark of quality in human services. CARF’s reputation for advancing excellence in the industry is founded largely on its unique peer review accreditation model, inclusive of its consultative survey, conformance focus, and evolving, field-driven standards.

    In today’s rapidly changing human services environment, excellence cannot be achieved by remaining static. Organizations must constantly change to remain relevant to their stakeholders. Leadership must drive and endorse change to ensure that the organization’s vision and mission are aligned with the needs and expectations of the persons served and positioned for organizational sustainability. Other personnel must identify, support, and execute change to enable the effective and efficient delivery of quality services. Systematic feedback loops must exist between leadership, personnel, persons served, and other stakeholders to provide the input necessary to identify needed change and effect appropriate response.

    In short, the achievement of excellence demands a practical method for continuous improvement that seamlessly integrates all organizational functions and the engaged input of all stakeholders. To address this demand, CARF has introduced the ASPIRE to Excellence® quality framework. In this framework, CARF’s business practice standards provide a logical, action-oriented approach to ensure that organizational purpose, planning, and activity result in the desired outcomes.

    Assess the Environment. To be relevant and responsive in a rapidly changing environment, the organization must be vigilant of the context in which it conducts its business affairs. Environmental assessments provide the foundation for development and implementation of organizational strategy. Assessments should be conducted within the context of the organization's purpose, location, and sphere of influence, and relate to the vision and mission of the organization and how both fit into the social, economic, competitive, legal, regulatory, and political environments in which the organization operates. Collection and analysis of information regarding these factors provide the basis for the creative thought necessary to guide all organizational planning and action toward a future of service and business excellence. The role of leadership is critical to environmental assessment.

    Set Strategy. Each organization has at its core a purpose developed through environmental assessment. Setting strategy is the activity of understanding the environment and organizational competencies, identifying opportunities and threats, and articulating a high-level map of the direction to take in order to achieve, sustain, and advance organizational purpose in a competitive environment. Strategy translates the salient environmental factors into tangible planning assumptions, sets goals and priorities, and globally aligns resources to achieve performance targets.

    Persons Served and Other Stakeholders—Obtain Input. In a service environment, organizational success cannot be achieved or sustained without success for the persons served. Actively engaging the persons served as part of the planning and service processes has been demonstrated to result in better outcomes. In fact, the more the organization obtains feedback from persons served and other stakeholders relative to all appropriate organizational functions, the better the outcomes reported. The important role of input from persons served and other stakeholders is recognized by its prominent position in the ASPIRE to Excellence framework. This input process engages all parties in a sense of shared future that promotes long-term organizational excellence and optimal outcomes.

    Implement the Plan. The strategic plan, based on a thorough assessment of environmental factors, provides a roadmap to achieving organizational purpose. To actually achieve its purpose, the organization must translate strategic goals into tangible action. Implementation is the development and enactment of tactical steps designed to achieve strategic goals. Sound implementation requires a solid foundation of service delivery and business practices operationalized via organizational resources, including personnel, technology, and assets. Excellence is attained through the translation of strategy into practices that, when performed by a competent workforce and enhanced by the effective use of available resources, achieves the desired outcomes.

    Review Results. To stay on target at both strategic and tactical levels, the organization must constantly monitor and assess its performance against a series of performance indicators and targets. Only by setting specific, measurable goals and tracking performance can the organization determine the degree to which it is achieving the desired service and business outcomes. Appropriate organizational and stakeholder representatives must review and analyze results to determine areas for improvement. This review and analysis positions the organization to develop and initiate quality improvement changes.

    Effect Change. Following the review and analysis of results, the organization must carefully evaluate the information learned so that it may be translated into focused actions to improve performance against targets. The evaluation drives the organization to engage in a dynamic, proactive process to review, renew, or revise its strategy and tactics, while ensuring alignment of organizational purpose, service and business practices, and organizational resources. Achieving excellence requires a disciplined continuous improvement process.

  • A flowchart of the ASPIRE quality framework

  • ASPIRE to Excellence® video

    View the ASPIRE to Excellence® video (Flash, 2 1/4 min.) to learn about CARF's framework for business practice standards. Or read the script.

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