Overview of Continuous Quality Improvement (CQI).
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Transcript of Overview of Continuous Quality Improvement (CQI).
First QSR Orientation Meeting
Meeting Objectives
• Introductions of QSR State Site Lead(s) and Local Site Lead(s)
• Overview of the Continuous Quality Improvement process and the role of QSR in that process
• Purpose of the Quality Service Review process – Case-specific review; Focus Groups and Key Stakeholder Interviews
• Overview of the components of the QSR process and timelines associated with the on-site review
• Overview of the QSR indicators• Composition of the review team
Continuous Quality ImprovementWhat it isn’t and what it is…
Continuous Quality Improvement (CQI) is not a time limited project or initiative. It is the ongoing process by which an agency makes decisions and evaluates its progress.
“A framework for implementation”Casey Family Programs & NRCOI
The DAPIMTM Model: A “Flywheel”
Implement Plan
Define
Performance& Capacity
Monitor Assess
-© 2009 American Public Human Services Association
What is a Quality Service Review?
• Measures child, youth, and family outcomes
• Reveals the practice model being used in actual cases.
• QSR is an organizational learning process offering helpful ways of knowing what’s working and not working in practice -- for which children and families and why.
• QSR connects results to local frontline conditions.
• QSR supports teaching & action learning processes that clarify expectations, provide useful feedback, and affirm good work.
• QSR stimulates actions taken to improve practice and results at all levels of the organization.
State and local review team members review case of one focus child/youth Brief review of the record Focused interviewers with members of the
child/family team Rates the status of the child/family and the system
performance on a 1-6 scale Written case review summary “tells the story” of
what was learned from the team
Immediate feed back to the Caseworker and Supervisor with strengths/needs/ recommendations
Case specific Agency specific
Focus groups with stakeholders and key stakeholder interviews
Debriefing with QSR Team Exit Conference of preliminary findingsFinal findings reportNext Steps Meeting
QSR Activities
QSR Case Reviews
QSR Focus Groups and
Key Stakeholde
r Interviews
DPW Licensure
Caseworkers
Supervisors
Other: may consider
youth, birth families,
foster families,
courts, etc.
Same cases as QSR sample
Stakeholder interviews
Feedback to Caseworker
and Supervisor
Additional intake, foster
home, and personnel files
Review for regulatory compliance
Written Case Summary
Aggregate quantitative
results
Summation, Discussion, Next Steps Planning
PA QSR Protocol: PA QSR Protocol: Child/Youth and Family Status Child/Youth and Family Status IndicatorsIndicators
PA QSR Protocol: PA QSR Protocol: Child/Youth and Family Status Child/Youth and Family Status IndicatorsIndicators
• 1a. Safety: Exposure to Threats of Harm1a. Safety: Exposure to Threats of Harm• 1b. Safety: Risk to Self/Others1b. Safety: Risk to Self/Others• 2. Stability2. Stability• 3. Living Arrangement3. Living Arrangement• 4. Permanency4. Permanency• 5. Physical Health5. Physical Health• 6. Emotional Well-being6. Emotional Well-being• 7. Learning & Development7. Learning & Development• 8. Pathway to Independence8. Pathway to Independence• 9. Parent & Caregiver Functioning9. Parent & Caregiver Functioning
PA QSR Protocol: Practice Performance IndicatorsPA QSR Protocol: Practice Performance IndicatorsPA QSR Protocol: Practice Performance IndicatorsPA QSR Protocol: Practice Performance Indicators• 1a. Engagement Efforts
• 1b. Role and Voice
• 2. Teaming
• 3. Cultural Awareness & Responsiveness
• 4. Assessment & Understanding
• 5. Long-Term View
• 6. Child/Youth and Family Planning Process
• 7. Planning for Transitions and Life Adjustments
• 8. Efforts to Timely Permanence
• 9. Intervention Adequacy & Resource Availability
• 10. Maintaining Family Connections
• 11. Tracking & Adjusting
Interpretive Guide for Child/Youth and Family Status Indicator Ratings
Unacceptable Range: 1-3 Acceptable Range: 4-6
Improvement Zone: 1-2 Refinement Zone: 3-4 Maintenance Zone: 5-6
Status is problematic or risky. Quick action should be taken to improve the
situation.
Status is minimum or marginal, may be unstable. Further efforts are necessary to refine the situation.
Status is favorable. Efforts should be made to maintain and build upon a
positive situation.
1 2 3 4 5 6
Adverse Status
Poor Status
Marginal Status
Fair Status Substantial Status
Optimal Status
The individual’s status in this area is poor, unacceptable and worsening.
Status is and may continue to be poor and unacceptable. Any risks may be mild to serious.
Status is mixed, limited or inconsistent and not quite sufficient to meet the individual’s short-terms needs or objectives now in this area.
Status is at least minimally or temporarily sufficient for the individual to meet short-term needs or objectives in this area.
Substantially and dependably positive status for the individual in this area with an ongoing positive pattern. Status is good and likely to continue.
The best of most favorable status presently attainable for this individual in this area (taking age and ability into account).
Final ReportQSR Findings Report
– Demographics – Child/Youth and
Family Status Domain
– Practice Performance Status Domain
– QSR Results Summary
– Key Questions to Consider for Next Steps Planning
Purpose:
The Next Steps Meeting is designed to be a starting point or continuation of the county’s efforts in the Continuous Quality Improvement (CQI) process which focuses on the development of an action plan for enhancing case practice and system performance.
Sponsor and Improvement Teams
Sponsor Team
Implementation Team
Work Grou
p
Sponsor Team• Defines high-level vision of CQI efforts• Secures resources • Creates and charters Improvement Team
Improvement Team• Guides CQI work day-to-day• Maintain hands-on responsibility for CQI
efforts• Charters and oversees smaller CQI work
groups• Communicates with Sponsor Team
Work Groups• Implement improvement efforts focused on
specific target areas• Representation from agency staff,
providers, consumers
Work Grou
p
Work Grou
p
County Improvement Plan (CIP)County Improvement Plan (CIP)Section I. Sponsor Team Members
Section II. Background
Section III. Priority Outcomes
Section IV. Findings
Section V. Strategies and action steps for each outcome
Bringing CQI to LifeReview and analysis of
CQI findings
(with focus on QSR results)
Identify recommend
ed improvement priorities
CQI Sponsor
Team creates
CQI Charter
and approve priorities
CQI Improvemen
t Team receives CQI Charter and
develops County
Improvement Plan
CQI Sponsor Team
reviews County
Improvement Plan and approves
for submission
to state
CQI Work Groups identify
and implement strategies
to actualize
CIP
Improvement Team
monitors and
analyzes work groups
CQI Sponsor
Team receives findings
CYS leadership, CQI staff,
with support of TA
Collaborative
What’s in it for your County?• Provides a great source of information
and data related to your specific case, related to agency trends, systems’ issues (report on each sample case generated after reviews)
• Supports the framework for the county’s current change efforts
• Case-specific improvement