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Metro Presentation August 15, 2014 Julia Harrison & Linda Peters FCCS Board Policy: Franklin County Children Services, its Board, advisory committees, and employees are committed to providing the highest quality services and to a continuous quality improvement process Administrative Support- resources CQI Plan: ◦ Describes how CQI is integrated into the agency’s work ◦ Highlights CQI services & activities that the PIE (Performance Improvement, IT, Evaluation, Data Mgmt, and Professional Development) Division will provide to the agency Council on Accreditation (COA) ◦ Non-direct service standards: Administration and Management Service Delivery Administration ◦ Direct service standards: Adoption Services Child Protective Services (Regions & Intake) Volunteer Mentoring Services Kinship Care Services CFSR/CPOE Orientation- CQI introduction for all new Committees are key employees, personal commitment ◦ “Effective committees can help us bring continuous improvements to our internal agency functioning and to the services we provide children and families. In addition, well-organized committees can help us draw on the talents of large numbers of staff, promote teamwork and enhance coordination across departments within the agency.” ◦ CQI Infrastructure ◦ Strengthens staff involvement in CQI activitieslearning environment a. b. c. d. e. Best Practice Council Committee Board and Administrative Policies Committee C3 (COA, CPOE, CFSR) Committee Chairs’ Cabinet Child Risk Review Committee i. Child Death Review Panel f. Clerical Committee g. Committee Communications Council h. Continuous Quality Improvement (CQI) i. CQI Short Term Plan (STP) Workgroups i. Employee Handbook Committee j. Executive Council k. Green Space Committee l. Information & Technology (IT) Review Panel m. Multi-Cultural Development n. Risk Management Committee o. Safety Committee p. Speaker’s Bureau q. Supportive Work Environment ROM and CFSR SACWIS data entry/data quality Automated data collection, analysis, and measurement consulting to CQI teams Ad hoc data analysis for BPC and CQI teams Provider services-placement provider scorecard Disseminate, analyze, and present the Survey of Employee Engagement (SEE) Provide reports to Program Services; Screening, Intake, Regions, and Adoptions to monitor performance- FCCS Dashboard Family Team Meetings; Case planning, 90 Day Reviews, SARs, TDMs, and PRTs Deceased Child Review Process- internal and external CPOE review and QIP monitoring CFSR review and PIP monitoring Peer Review- transition from QA approach to CQI Adoption Services - MEPA compliance, process review of pre-matching & conferences Child Protective Services/Intake - CAPMIS; Safety & Family Assessment timeliness & quality Child Protective Services /Regions – CAPMIS; Case Plan & Reunification Assessment timeliness & quality Volunteer Mentoring Services – Process review for provider approval, matching, maintenance, and documentation Kinship Care Services – Process review for timeframes, quality of documentation, and activity logs for quality “Cross-pollination” workgroup- CAPMIS Safety Plan timeliness & quality Shift from QA style, 3rd party reviews focused on compliance Identify strengths and areas needing improvement Aim is to improve practice/outcomes and align with Rule Involving employees and stakeholders; ensuring staff are engaged and part of the entire process. Focus on supervisors! Data gathered, analyzed, & reported at case and aggregate levels Using data, team knowledge, and collaboration to improve decision-making and bring systemic improvements Link Strategic planning, goal setting and monitoring improvements Peer reviews for a process, specific tool, program, or case Useful for individual workers/unit, refresher training, coaching/mentoring Continuous cycle –repeat the process! PIES PLAN IMPLEMENT EVALUATE next STEPS ◦ SHARE Results ◦ STRATEGIZE ◦ SUSTAIN **CQI STP Workgroups-where the work happens-Program service supervisors, caseworkers, & administrators **Use PID Peer Reviewers to Facilitate **Partner with Evaluations, IT, PDD, others ◦ Select a process, specific tool, program, or a case ◦ Determine what is to be improved. Focus on timeliness, quality, efficiency, accuracy, etc. ◦ Develop a peer review tool from ORC/OAC, CAPMIS/SACWIS, COA, Agency policies & procedures ◦ Create instructions/guides, tool and answer sheet ◦ Determine the pool, sampling, timeframes, etc. ◦ Detail logistics of reviewers, process, assignment, collecting and recording data ◦ Get baseline data to help determine goals ◦ Evaluation plan – measuring, operationalize/define; for quality use; y/n, OR not, substantially, or partially achieved. ◦ Communication plan- how to share results, not punitive, unit level may spur competition, STPs/departments and “BIG” CQI, agency-wide ◦ Think about IMPROVEMENTS and Strategies ◦ Get started, per the plan ◦ Use the STP workgroup/committee members as subject matter experts/champions ◦ Be flexible; things will change; tools, instructions; continuous learning ◦ Need oversight, responsibility, keep things moving- CQI timeline ◦ Data and evaluation are key-analyze results, goals, progress ◦ Communicate as you go! Share with CQI Workgroup, BIG CQI, agency-wide ◦ Improvement strategies; policy/procedures, SACWIS, agency processes, training, tools-Red Letter Guides, Q-tips, Reports ◦ Campaigns/competition- reward success! ◦ Gather data and compare peer review results, baseline and improvements ◦ Automate our process- Scantron & EXCEL ◦ Create reports and charts to show analysis of data- remember your audience! ◦ Report at supervisor level – not worker level, not for performance evaluations ◦ Set goals and benchmarks, determine when improvement is reached ◦ Remember to evaluate the process and implementation as well- satisfaction surveys SHARE Results, STRATEGIZE, and SUSTAIN ◦ Share-- communicate results, remember your audience, REWARD success! All levels-individual, supervisor, dept., agency wide. Use FCCS rotator, bathroom posts, “best” peer reviews, campaigns like QTSA, Awesome sauce, Father’s Day cards & Engagement ◦ Strategize--Identify areas for improvement, ideas/strategies to use. Plan for improvementsprocess, clarification of policies/guides, Q-tips, training/education, measuring/monitoring with reports ◦ Sustain—through accountable processes, use data, SACWIS, reports & monitoring, FCCS Dashboard FCCS Region CQI STP group worked to improve the timeliness and quality of CAPMIS RAs. Support FCCS PIP activities for more inclusive peer review process, supervisor involvement , CAPMIS tool improvements, and improvements in CFSR 1.1 – Timeliness & Permanency of Reunification. FCCS Baseline data indicated that RAs were not being completed or used as a tool to drive decision-making. Also inconsistency among Regions, units, supervisors, or workers in the completion and quality of the RAs. Timeliness and quality had to be defined and operationalized. ◦ Timeliness determined to be completion 0 to 30 days prior to the youth’s discharge. ◦ Quality was determined by thorough review of SACWIS, CAPMIS and the RA tool with changes in agency policies and procedures, creation of instructions, and a Red Letter Guide. ◦ Additional training and quality tips (Q-tips) ◦ Data was instrumental and reports were analyzed and shared so that progress was evident. 2012 74 2011 17 45 31 9 24 Timely Not Timely 2010 41 27 32 Not Completed 2009 38 0% 10% 20% 28 30% 40% 50% 34 60% 70% 80% 90% 100% Q1 2012 77% Q4 2011 80% Q3 2011 79% Q2 2011 77% Q1 2011 72% Q4 2010 65% Q32010 66% Q2 2010 69% Q1 2010 56% Q4 2009 59% Q3 2009 56% Q2 2009 34% 0% 10% 20% 30% 40% 50% Overall Quality Score 60% 70% 80% 90% 57% 33% 1% 9% Strongly Disagree Disagree Agree Strongly Agree