Transcript No Slide Title

Continuous Quality
Improvement within a
System of Care Context
Brigitte Manteuffel, Macro International,
Inc.
Beth Dague, Project Director, Cuyahoga
Tapestry
Chris Stormann, Evaluator, Cuyahoga
Tapestry
Teresa King, Family Lead, Cuyahoga
Tapestry
2006-07 System of Care Start-up Webinar Series
Objectives
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Understand a basic framework for Continuous Quality
Improvement

Understand how to use data to inform your
community‘s CQI processes
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Learn, through real examples, the importance of
collaboration among evaluators, managers, families and
other key stakeholders, to generate effective
improvement strategies
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Learn how to "close the loop" by asking and answering
the question: Are our improvement strategies working?
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Identify tools and other resources available to
communities to develop and strengthen their own
CQI processes.
2006-07 System of Care Start-up Webinar Series
What is Continuous Quality
Improvement (CQI)?
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Program reflects the wishes and needs of the
community being served
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Program continually improves and moves
toward meeting program goals
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Outcomes are measured, monitored and
achieved
2006-07 System of Care Start-up Webinar Series
CQI Key Principles
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Is an ongoing process that requires a team
approach with multiple perspectives
Starts with a program logic model
Involves using data to identify whether
implementation is consistent with the logic
model
Requires real dialogue around areas in need of
improvement and what can be done to improve
Focuses on developing an infrastructure to
address the problems; not just a one time
solution
2006-07 System of Care Start-up Webinar Series
Data-driven Tools to Support CQI
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Key to the CQI process
If done correctly, allows you to:
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Assess whether implementation is following what was
defined in the logic model
Identify areas where plans have deviated and why
Reassess priorities or expectations
Identify and implement improvement plans
2006-07 System of Care Start-up Webinar Series
Systems of Care CQI Framework
Monitoring Progress:
Evaluation
Theories of Change:
Logic Model
Continuous
Quality
Improvement
Improving and Sustaining
Change:
Improvement Plans
2006-07 System of Care Start-up Webinar Series
Logic Model as the Framework for
CQI
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Start with a logic model
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Identify desired outcomes
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Desired outcomes provide guidance for
developing performance measures
2006-07 System of Care Start-up Webinar Series
Comprehensive Community Mental Health Services for Children & Their Families
>> Accountability >>
>> Adaptation >>
Logic Model
Population
Practice Context
• Practices have traditionally
promoted the use of
restrictive placements and
services
The mission of the
Comprehensive
Community Mental
Health Services for
Children and Their
• Need coordination among
service providers
Families Program
is to encourage the
Child & Family Context
development of
community-based
services for
children with
serious emotional
disturbance and
their families based
on a multi-agency,
multi-disciplinary
>> Quality Improvement >>
intensive
• Children under 22 years of
age and their families
• Diagnosis of emotional,
behavioral, or mental
disorder
• Level of functioning in
family, school, and/or
community environments is
limited
• Two or more community
agencies involved
approach involving
• Disability must be present
at least one year
both the public and
System Context
private sectors.
• Federal Center for Mental
Health Services funds and
supports systems of care
with: Leadership, Technical
assistance, Consultation,
Evaluation
• Local matching funds and
resources
• Need for comprehensive
array of community-based,
culturally competent and
family-focused services
• Need for family advocacy
• Family-focused: Services and
supports should consider the
needs and strengths of the entire
family.
• Individualized: Services and
supports should be tailored to
the needs and strengths of each
child and family.
System of Care Strategy
Local Service Delivery Process:
System entry, service planning, service provision, and
review/monitoring of the care of individual children and
families
• Culturally competent: Services
and supports should be sensitive
and responsive to the cultural
characteristics of children and
their families.
• Least restrictive: Service
planning should balance a child
and family's need to interact in
school and community settings
with the most appropriate
services and supports.
Core Values are
Family-driven
Culture-based
• Community-based: Services
and supports should be
provided in the child and
family's community.
• Coordination/collaboration:
Partner agencies, providers
and organizations should
provide a seamless system of
services and supports for
children and families.
<< Internal Evaluation <<
• Service providers integrate
system of care principles
and values into practice
• Children and families
receive coordinated and
useful services and
supports in the community
Child and Family Outcomes
• Children's distressing
symptoms are reduced
Individualized
& flexible services/supports
Family & child
partners
Community member
partners
State & Federal
agency partners
Local agency
& organization
partners
Community
ownership and
planning
• Children have improved
ability to function at home,
in school, and in their
community
• Improved family
functioning and reduced
caregiver strain
System Outcomes
• Families are full partners
in policy and
implementation
• Agency partnerships are
broadened and deepened
• Accessible: Access to
services and supports should
not be limited by location,
scheduling or cost.
• Interagency: Core agencies
providing services and
supports should include
mental health, child welfare,
juvenile justice and
education.
Outcomes
Practice Outcomes
Local Infrastructure Development:
Governance, management, quality monitoring and array of
services/supports
• Comprehensive,
coordinated, efficient, and
accountable service array
is developed
• Resources are
appropriately allocated
and utilized locally
• System of care is
sustained with stable,
long-term funding
• Child and family
satisfaction with services
is improved
2006-07 System of Care Start-up
WebinarResearch
Series<<
<< Using Best/Current
Evaluation and feedback to support improved service delivery
• Service providers need to
meet multiple needs of
children and families that
cross agency boundaries
Guiding Principles
Questions??
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Please press *6 to re-mute your line
after your question has been
answered.
2006-07 System of Care Start-up Webinar Series
Cuyahoga Tapestry
System of Care
(Cleveland, Ohio)
The CQI Process and Collaboration
Using the CQI Progress Report
2006-07 System of Care Start-up Webinar Series
Community Collaboration:
Our experience.…
Being a pilot site is a wonderful thing
 Interpreting the measures and delving into
the details
 Understanding the meaningfulness of the
data at the local level
 Being comfortable with saying “I have no
idea what this means”
 It says right here we are terrible!
 It says right here we are great!
 Staying strengths-based
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2006-07 System of Care Start-up Webinar Series
CQI Collaboration with Local
and National Partners
Forming a CQI team/workgroup
 Prioritizing the indicators
 Talking about how to affect and monitor
change
 Providing information to the community
about the CQI data
 Drawing on past experience
 Networking with other grant communities
 National partners and supports
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2006-07 System of Care Start-up Webinar Series
Providing Information to the Community
about the CQI data : Seeing the Big Picture
√++
Total site score and domain
score
2006-07 System of Care Start-up Webinar Series
Identifying Priorities: Start Small…
But Start Somewhere!
2006-07 System of Care Start-up Webinar Series
Next Steps
Continue to understand the measures
better
 Be an active consumer and developer of
CQI
 Work closely with providers and “change
agents” to get buy-in…people must believe
these are meaningful indicators if they are
going to act on them
 Start a “what can I do about this?”
dialogue
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2006-07 System of Care Start-up Webinar Series
Next Steps
Build strategies for change around priority
indicators
 Connect with TA partners and look at
available supports to help improve
 Implement change strategies
 Closely watch performance in future CQI
reports
 Hard to get it right the first time, be ready
to try new strategies
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2006-07 System of Care Start-up Webinar Series
Questions??
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unmute your line.
Please press *6 to re-mute your line
after your question has been
answered.
2006-07 System of Care Start-up Webinar Series
Resources from the
National Evaluation to
Support CQI
The CMHS CQI
Benchmarking Initiative
2006-07 System of Care Start-up Webinar Series
CQI Benchmarking Initiative
Purpose
Use data to guide quality improvement
activities
 Support technical assistance planning
and resource allocation
 Track progress toward meeting
program goals and objectives
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Ensure quality of outputs and
outcomes of the sites, program
partners, and the branch
2006-07 System of Care Start-up Webinar Series
CQI Progress Report
Primary Objectives
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Provide a data-driven tool to support CQI
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Support data-driven technical assistance
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Produce national and community/site level
data reports
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Track progress/performance over time
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Promote utility-focused data reporting
2006-07 System of Care Start-up Webinar Series
CQI Benchmarking Initiative
Process
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CQI Development Team
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Consensus on key areas to measure and on
indicators
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Broad representation from program stakeholders
Modeled after program goals and objectives
Launched reports in April 2005
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Encouraged community feedback
2006-07 System of Care Start-up Webinar Series
CQI Progress Report
Key Areas of Performance
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The CQI Progress Report is organized
into 6 key areas of performance to
include:
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System Level Outcomes
Child and Family Level Outcomes
Satisfaction with Services
Family and Youth Involvement
Cultural and Linguistic Competency
Evidence-based Practices
2006-07 System of Care Start-up Webinar Series
CQI Progress Report
2006-07 System of Care Start-up Webinar Series
Questions and Comments
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unmute your line.
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after your question has been
answered.
2006-07 System of Care Start-up Webinar Series
Contact Information

Brigitte Manteuffel (Macro International, Inc):
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Beth Dague, Project Director, (Cuyahoga
Tapestry): [email protected]

Chris Stormann, Evaluator, (Cuyahoga
Tapestry): [email protected]

Teresa King, Family Lead, (Cuyahoga
Tapestry): [email protected]
[email protected]
2006-07 System of Care Start-up Webinar Series