Transcript Pennsylvania’s Quality Service Review (QSR) Protocol

Pennsylvania’s Practice Model
and Quality Service Review
(QSR) Protocol
Leadership Academy
Conference
September 29, 2010
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Activity
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What do you want children, youth, and
families to achieve as result of your
intervention?
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What do you want children, youth, and
families to experience as you work
with them?
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Practice Model Defined
(NRCOI, a working document series, July 2008)
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It is the agency’s guide to the daily
interactions among employees, children,
families, stakeholders, and community
partners working together to achieve defined
outcomes.
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It should be the explicit link connecting the
agency’s policy, practice, training,
supervision, and quality assurance with its
mission, values, and strategic plan.
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Measures child, youth, and family outcomes
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Reveals the practice model being used in actual cases.
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QSR is an organizational learning process offering helpful ways of
knowing what’s working and not working in practice -- for which
children, youth and families and why.
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QSR connects results to local frontline conditions.
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QSR supports teaching & action learning processes that clarify
expectations, provide useful feedback, and affirm good work.
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QSR stimulates actions taken to improve practice and results at all
levels of the organization.
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Pennsylvania background
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Practice Standards
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A non-regulatory method of establishing
benchmarks for defining optimal, but
achievable, results for child welfare
services in Pennsylvania.
Evolution of standards
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Pennsylvania background (continued)
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Quality Service Review history
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CFSR round 1
CFSR round 2
What’s different from round 1 to 2
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PA’s Model of CQI
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State and local review team to review one case
• Review of the record
• Focused interviewers with every member of the child/family TEAM
• Rates the status of the child/family and the system performance on a 1-6
scale
• Narrative that “tells the story” of what was learned from the TEAM
Immediate feed back to CW and Supervisor with
strengths/needs/recommendations
• Case specific
• Agency specific
Includes focus groups with stakeholders
Debrief of preliminary findings
Final findings report
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Indicators in the PA QSR Protocol
Child, Youth and Family Status Indicators
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1a. Safety: Exposure to Threats of Harm
1b. Safety: Risk to Self/Others
2. Stability
3. Living Arrangement
4. Permanency
5. Physical Health
6. Emotional Well-being
7a. Learning & Development: Early Learning and Development
7b. Learning & Development: Academic Status
8. Pathway to Independence
9. Parent and Caregiver Functioning
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Indicators in the PA QSR Protocol
Practice Model Functions
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1a. Engagement: Engagement Efforts
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1b. Engagement: Role & Voice
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2. Teaming
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3. Cultural Awareness & Responsiveness
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4. Assessment & Understanding
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5. Long-Term View
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6. Child/Youth and Family Planning Process
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7. Planning for Transitions and Life Adjustments
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8. Timely Permanence
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9. Intervention Adequacy & Resource Availability
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10. Maintaining Family Relationships
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11. Tracking & Adjusting
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QSR Interpretative Guide for Practice Performance Indicator Ratings
Maintenance
Zone: 5-6
6 = OPTI MAL & ENDURING PERFORMANCE
. Consistent, effectiv e practicefor the
person in this area for thepast 6 monthsor since admission if less. The lev el of
performance is indicativ e ofexemplary practice and results
for the person.
Performance is effectiv e.
Efforts should be made to
maintain and build upon a
positiv e practice situation.
5 = GOOD ONGOING PERFORMANCE
. The practice function isw orking dependably for the person, under changing conditions ov er the
past 3 months.
Effectiv eness lev el isconsistent w ith long-term outcomes
for the person.
Refinement
Zone: 3-4
4 = FAIR PERFORMANCE
. Performance isminimally or temporarily sufficient to
meet short-term need or objectiv es
. Performance in this area of practice has
been no less thanminimally adequateat any time in thepast 30 day ,s but may
be short-term due to changing circum stances, requiring change soon.
Performance is minimal or
marginal and may be
changing. Further efforts
are necessary to refine the
practice situation.
Improvement
Zone: 1-2
Performance is inadequate.
Quick action should be
taken to improv e practice
now .
Acceptable
Range: 4-6
3 = MARGINALLY INADEQUATE PERFORMANCE
. Practice may beunderpow ered, inconsistent or not w ell-matched to need
. Performance isinsufficient at
times or in some aspects for the person to meet short-term needs or objectiv
. es
With refinement, this could becom e acceptable in the near future.
2 = POOR PERFORMANCE
. Practice isfragmented, inconsistent, lacking necessary intensity , or off-target
. Elements of practice may be noted, but it is
incomplete or not operativ e on a consistent or effective basis
.
Unacceptable
Range: 1-3
1 = ADVERSE PERFORMANCE
. Practice may beabsent or not operativ .e
Performance may bemissing (not done). - OR - Practice strategies, if occurring
in this area, may be contra-indicated may
or be performed inappropriately or
harmfully.
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Activity
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Rate a scenario based on assigned
indicator with your partner
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Discuss ratings
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Next steps: connections to CQI
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Finalization of QSR protocol and process
(including manual and training
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Roll out of CQI in phased-in approach
across the state
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Finalization Of Practice Model & Resource
To Support Implementation (GUIDE BOOK)
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How can I get involved?
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If you are not a phase one county, are
you interested in phases two or three?
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Can volunteer staff to be reviewers in
phase one county QSRs
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Who to contact for more information:

Mike Byers
[email protected]
(717) 795 - 9048
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Stephanie Maldonado
[email protected]
(717) 783 – 7376
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Jeanne Schott
[email protected]
(717) 795 - 9048
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