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The concept of quality of life currently impacts program development, service delivery, management strategies, and outcome evaluation in the area of intellectual disabilities. Maryland uses peer interviewers to assess consumer-perceived quality of life among adult recipients of MR/DD services and supports. In this article we describe the survey instrument and procedures and discuss assessment issues of quality of responses, acquiescence, and proxy respondents. We present the psychometric properties for eight core quality of life domains among 923 people assessed in FY 2001. Results are summarized and development of a model for enhancing social inclusion, personal development, and self-determination was described. Service and personal characteristics relating to quality of life as well as some ways the results can be used for program enhancement are discussed.

Education and rehabilitation programs in the field of intellectual disabilities are developing specific strategies related to demonstrated personal outcomes, quality of life (QOL)‐related services and supports, evidence‐based practices, and quality improvement. The purpose of this article is to summarize key aspects of these strategies within a two‐component framework: the concept of QOL and systems thinking. Based on our collective experiences and published literature, four specific strategies are presented and discussed: mental models, assessment, service delivery practices, and quality improvement (QI). Essential guidelines for the successful implementation of these strategies are then presented, along with an exemplary application of each strategy. Each example shows the significant role of the consumer, the organization, and the larger system in organizational change, QI, and the enhancement of personal outcomes.

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