Transcript Pennsylvania’s Quality Service Review (QSR) Protocol

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 – Casespecific 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 Improvement
What 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”
Define
Monitor
Assess
Performance
& Capacity
Implement
Plan
-© 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 findings
Final findings report
Next Steps Meeting
QSR Activities
QSR Case
Reviews
QSR Focus
Groups and
Key
Stakeholder
Interviews
DPW
Licensure
Stakeholder
interviews
Caseworkers
Same cases as
QSR sample
Feedback to
Caseworker and
Supervisor
Supervisors
Written Case
Summary
Aggregate
quantitative
results
Other: may
consider youth,
birth families,
foster families,
courts, etc.
Additional
intake, foster
home, and
personnel files
Review for
regulatory
compliance
Summation, Discussion, Next Steps Planning
PA QSR Protocol: Child/Youth and Family Status
Indicators
•
•
•
•
•
•
•
•
•
•
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
7. Learning & Development
8. Pathway to Independence
9. Parent & Caregiver Functioning
PA 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 shortterms needs or
objectives now 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).
Status is at least
minimally or
temporarily
sufficient for the
individual to meet
short-term needs
or objectives in
this area.
Final Report
QSR Findings Report
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–
–
–
–
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
• Defines high-level vision of CQI
efforts
• Secures resources
• Creates and charters Improvement
Team
Sponsor
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
Implementatio
n Team
Work
Group
Work
Group
Work
Group
Work Groups
• Implement improvement efforts
focused on specific target areas
• Representation from agency staff,
providers, consumers
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 Life
CQI
Sponsor
Team
receives
findings
Improvement
Team
monitors and
analyzes
work groups
CQI Work
Groups
identify and
implement
strategies to
actualize
CIP
Review and
analysis of
CQI findings
(with focus
on QSR
results)
CYS
leadership,
CQI staff, with
support of TA
Collaborative
CQI Sponsor
Team reviews
County
Improvement
Plan and
approves for
submission to
state
Identify
recommende
d
improvement
priorities
CQI
Sponsor
Team
creates
CQI
Charter
and
approve
priorities
CQI
Improvement
Team
receives CQI
Charter and
develops
County
Improvement
Plan
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