1 Measuring Quality Using Experience Surveys 2005 Center for Policy and Innovation Quality Assurance...

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Measuring Quality Measuring Quality Using Experience Using Experience

SurveysSurveys20052005

Center for Policy and Innovation

Quality Assurance and Improvement

January 26, 2006

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Critical optimism “is the belief that the specific conditions which exist at one moment, be they comparatively bad or comparatively good, in any event may be bettered”.

(John Dewey, 1929)

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DADS MissionTo provide a comprehensive array of aging and

disability services, supports, and opportunities that are easily accessed in local communities.

Our key responsibilities to the citizens of Texas include:

Working in partnership with consumer, caregivers, service providers, and other stakeholders.

Developing and improving service options that are responsive to individual needs and preferences

Ensuring and protecting self-determination, consumer rights, and safety.

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Purpose

Obtain information from the person’s perspective about their experiences

Obtain initial baseline of data to build upon

Conduct surveys annually in order to trend and analyze

Data will point to areas for further exploration

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Measuring Quality

One of only a few states to undertake a project of this size and scope

1,980 face-to-face surveys in the HCS, TxHmL, ICF/MR, CLASS, DB-MD, CBA, and CWP for 18 years and older

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Introduction

DADS joined National Core Indicator Project in September 2005

Contracted with NACES Plus Foundation, Inc. to conduct the surveys

Interviews conducted May through August Interviews conducted annually to identify

trends

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Quality Indicators

National Core Indicators (NCI)

30 Indicators 4 Domains

– Consumer Outcomes– System Performance– Health, Welfare, and

Rights– Self-Determination

(added by the QA/QI Task Force)

Participant Experience Survey (PES)Elderly/Disabled version

39 Indicators 5 Domains

– Access to Care– Choice and Control– Respect/Dignity– Community

Integration/Inclusion– Self-Determination (added

by QA/QI Task Force)

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Methodology

Proportional sampling based on number of people in each program by county

Interviews were conducted in the person’s home unless person chose not to

Interviews were conducted in about one-half of the counties across Texas

Demographics from DADS automated systems of people receiving services

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Training

Conducted in April 2005 In person by developers of tools Mock interviews with persons receiving

services Regular conference call with interviewers Frequently asked questions collected and

distributed

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It is important to use the data as a basis for further discussion and inquiry in

order to “interpret” or draw conclusions from the results.

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Next Steps

Internal review of results Share with QA/QI Task Force to:

– Review results and identify/prioritize areas for improvement or further study

– Develop strategies for making improvements

Broader stakeholder input

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High-Level Results

Majority of people in HCS, TxHmL, ICF/MR, CLASS, DB-MD, and CWP report:– They receive the services they need– Have had a physical exam in the past

year– Do not feel lonely

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Results - continued

Majority of people in HCS, TxHmL, and CLASS are satisfied with where they live

Majority of people in HCS, TxHmL, ICF/MR, CLASS, and DB-MD participate in integrated activities in their communities

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Results - continued In the HCS, TxHmL, ICF/MR, CLASS, DB-

MD, & CWP a low proportion of:– Women had OB/GYN exams in the last year– People have participated in activities of self-

advocacy groups– People were provided options about where to live

and work– People made choices about important life

decisions including: housing, roommates, support staff or providers, daily routines, social activities, job, and services coordination

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Results - continued

The majority of people in the CWP & CBA Programs:– Are able to eat when they need to

because there is someone there to help them.

– Have chosen their current job– Like their current job

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Results -continued

69% of people in CWP and 39% of people in CBA do not choose their staff but

would like to 50% of people in CWP and 64% of people in

CBA report an unmet need for community involvement

Over one-third of people in CWP who are not elderly would like to work

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Home and Community-Based Services (HCS)

Highest satisfaction with the following:

93% - “needed” services were available 92% - have had a physical exam in the past

year

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Home and Community-Based Services (HCS)

Lowest satisfaction with the following: 16% - people have participated in activities

of self-advocacy groups or other groups that address rights

17% - people make choices about important life decisions including: housing, roommates, support staff or providers, daily routines, social activities, job and services coordination

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Texas Home Living (TxHmL)


93% - “needed” services were available

93% - do not feel lonely

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Texas Home Living (TxHmL)

Lowest satisfaction with the following: 14% - women have had an OB/GYN

exam in the past year 9% - people have participated in

activities of self-advocacy groups or other groups that address rights

7% - people report having been provided options about where to live

16% - people indicate that most staff who come to their home treat

them with respect **72% reported having no staff who come to their home

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Intermediate Care Facilities for Persons with Mental Retardation

(ICF/MR)


98% - “needed” services were available 96% - have had a physical exam in the past

year

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Intermediate Care Facilities for Persons with Mental Retardation

(ICF/MR)

Lowest satisfaction with the following: 12% - have participated in activities of self-

advocacy groups or other groups that address rights

16% - report having been provided options about where to live

15% - report having been provided options about where to work

9% - people make choices about important life decisions about; housing, roommates,support staff or providers, daily routines, social activities, job, and services coordination

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Community Living Assistance and Support Services (CLASS)


93% - “needed” services were available 96% - have had a physical exam in the

past year

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Community Living Assistance and Support Services (CLASS)

Lowest satisfaction with the following: 10% - women have had an OB/GYN exam

in the past year 14% - people report having been provided

options about where to live 9% - people report having been provided

options about where to work

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Deaf-Blind with Multiple Disabilities (DB-MD)


98% - “needed” services were available 90% - have had a physical exam in the

past year 92% - do not feel lonely

Results are valid plus or minus 9.4 percent because of the small sample size.

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Lowest satisfaction with the following: 15% - people have participated in

activities of self-advocacy groups or other groups that address rights


10% - people report having been provided options about where to work

15% - people have an “advocate” or someone who speaks on their behalf

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Lowest satisfaction with the following: 18% - people report that service

coordinators help them get what they need

20% - people who report that they feel safe in their home

20% - people who report that they feel safe in their neighborhood

20% - people whose basic rights are respected by others

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Consolidated Waiver Program (CWP)

Using the NCI Survey

Highest satisfaction with the following: 88% - “needed” services were available 84% - do not feel lonely 78% - have had a physical exam in the

past year

Results are valid no more than plus or minus 9.6 percent because of the small sample size.

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Using the NCI Survey

Lowest satisfaction with the following: 4% - women have had an OB/GYN exam in the

past year 20% - people have participated in activities of

self-advocacy groups or other groups that address rights


18% - people make choices about important life decisions including: housing, roommates, support staff or providers, daily routines, social activities, job, and services

coordination

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Using the PES Survey

Major findings from the PES indicators:

3% - are not treated respectfully by staff in their homes

3% - are verbally abused by current staff


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Other major findings:

69% - do not choose their care staff, but would like to

50% - report an unmet need for community involvement


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Community Based Alternatives (CBA)


Major findings from the PES indicators: 3% - sometimes go without a meal

because there is no one there to help them

3% - are unsure who to report staffing problems to or would report staffing problems to “no one”

2% - are sometimes unable to eat because there is no one there to help them

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Community Based Alternatives (CBA)


Other major findings: 37% - earn enough money to buy the

things they want 39% - do not choose their care staff,

but would like to 64% - report an unmet need for

community involvement

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