The Continuous Quality Improvement Process Empowering staff to develop local level solutions

The Continuous Quality Improvement Process

Empowering staff to develop local level solutions

CQI Supports the CD Mission Statement

To partner with families, communities and

government to protect children from abuse and

neglect and assure safety, permanency and well being

for Missouri’s children.

CQI Supports our Guiding Principles

ProtectionPermanency

PartnershipPracticePreventionProfessionalism

CQI Philosophy

• A process by which all staff look at the agency as a whole and develop plans for improvement

• CQI is intended to evaluate the effectiveness and efficiency of services provided

• CQI will help us become a “Learning Organization” and assists us in meeting the G2 Accreditation Standard

Components of the CQI System

Staff SurveysPeer Record Reviews (PRR)

Program Development Reviews (PDR)

Outcome Reports

Management Reports

CQI Process

Consumer Surveys

Grievance Data

Outcome Reports

• 20 Critical Outcome Measures across all program lines each fitting into the domains of safety and permanency

• Reported quarterly on the intranet at http://dssweb/cs/outcomes/index.htm

• Used to track progress in the Program Improvement Plan (PIP)

• Quantitative data derived from information staff enter in our data systems

Monthly Management Reports (Pink Books)

Monthly publication available on the intranetregarding:

- CA/N- FCS- FCOOHC- IIHS

Peer Record Reviews

• Peer to Peer Review which ensures essential service components exist in the record

• Intended to be supportive in nature, findings are to be shared with staff

• Worker gains new perspective and reviewer’s knowledge and skills are enhanced

• 10% of CA/N, FCS, and FCOOHC cases are reviewed

Consumer Grievance Data

• Structured so service delivery issues can be addressed at the most local level possible

• Allows families the opportunity to express concerns about dissatisfaction with agency action or behaviors

• Aggregate grievance information should be reviewed during CQI meetings

Practice Development Reviews (PDRs)

• Used to examine outcomes for individual children and families and the service system as a whole

• Combination of qualitative and quantitative data

• Very small sample – 12 to 24 cases

• Frequency yet to be determined

Consumer Surveys

Random sample of Surveys generated from Research and Evaluation and sent to :

Active youth in careAdults served in active FCSAdults served in IISAdults recently involved in CA/N reportActive Foster/Relative care providers

The Survey of Organizational Excellence

• Survey of all staff conducted annually

• Allows detailed (circuit and state level) organizational information to be collected

• Results posted on intranet for use in CQI meetings

• Response rate has risen from 18% in 2002 to 70% in 2005

CQI Meetings

• Underlying Principles

• Purpose

• Agendas

• Team Roles

• Meeting Focus

Underlying Assumptions of CQI• The CQI process involves

multiple levels of team meetings

• Every person is part of a CQI Team

• Each team sends one representative to the next level meeting

• All CQI meetings and team members are of equal importance

• 90% of the issues are resolved at the level that first identified the issue

1st Level

2nd Level

3rd Level

State

Purpose of CQI Meetings

• Opportunity create solutions for problems

• Creative action planning with colleagues

• Innovative implementation of staff ideas

• Starting where we really are (honestly) and building on it

• Taking full advantage of opportunity to be creative and achieve the mission

Non-Purposeof CQI Meetings• Gripe session

• Social Hour

• Passing the buck for solving problems to someone else

• Using the time to simply “bash” current data or people

• “This is just another passing fad – I’ll wait it out and it will go away”

CQI Meeting AgendasCQI Meeting Agendas Any Service Delivery IssueAny Service Delivery Issue Have an agendaHave an agenda 90 minutes every quarter90 minutes every quarter Review of Review of In FocusIn Focus CQI Newsletter CQI Newsletter Examination of Program Evaluation Examination of Program Evaluation

Data (PRR, Outcome Reports etc)Data (PRR, Outcome Reports etc) Review of past issues Review of past issues Updates on new projectsUpdates on new projects Reviews of incidents, accidents, Reviews of incidents, accidents,

grievancesgrievances

Issues/ Concerns What Are We Going To Do?

By Whom Due Date Desired Outcome

Summary of Data Reviewed:

AGENDA TOPICS_____ Incidents, Accidents, and Client Grievances _____ Staff/Client Satisfaction Data_____ Program Evaluation Data _____ Peer Record Review Data_____ Improvement Projects _____ Safety and Risk Management_____ Other _____ Past Issues_____ Outcome Data

CQI Meeting Activity Log

Location (Office/County/Circuit/Region/State Office): Date: Participants:

First Level TeamsFirst Level Teams

Issues resolved and implementation begins

Unresolved Issues8 to 12

CD Staff at all levels

Second Level TeamsSecond Level Teams

Issues resolved and implementation begins

Unresolved Issues

•Leaders of First Level Teams

•Juvenile Court Rep.

•Foster Parent

•Youth Consumer

•Adult Consumer

•Service Provider

•Site Coordinator or Unit Manager

•Site Rep. Or Unit Sup. Staff

•FSD Staff Rep.

Third Level TeamsThird Level Teams

Issues resolved and implementation begins

Unresolved Issues

•Leaders from Second Level Teams

•Regional CD Adm./Program Staff

•Regional REP to Sate Foster Parent Advisory Board

•Rep. From Area Youth Advisory Board

•Juvenile Court Rep.

•Adult Consumer

•DMH Rep.

•DCDE Rep.

State Level TeamsState Level Teams

Issues resolved and implementation begins

Issues that remain unresolved and feedback from direct staff is sought

•Leaders from 7 Regional Teams

•Regional directors or CD Administrators

•Central Office Unit Mngrs.

•CD Administrators

•Rep. From Sate Foster Parent Advisory Board

•Rep. From State Youth Advisory Board

•Rep. From Sate Court Adm. Office

•Rep. From Citizens for Missouri’s Children

•Adult Consumer

•FSD Staff Rep.

•DMH Rep.

•DCDE Rep.

CONTINUOUS QUALITY IMPROVEMENT PROCESS

TEAM MEMBER ROLES

• Leader

• Facilitator

• Scribe

Leader Tasks

• Opens team meetings and briefly outlines the process

• Represents the Team at the next Level• Report back to the team from the next level

meeting• Support and strengthen team productivity • Train the leader for the next year• Read through the CQI Activity log with the

Scribe to ensure clarity

Facilitator Tasks

• Set up CQI agenda with Scribe• Facilitate the meeting process• Maintain focus on the tasks at

hand• Generate a team consensus of

what items will be advanced to the next level and what can be addressed locally by the team

• Train the facilitator for next year

Scribe Tasks• Arrange a meeting place• Work with the facilitator to prepare the agenda• Issue a reminder of the meeting to all members• Copy and distribute materials to team members (In

Focus Newsletter, Agenda, etc)• Take minutes using CQI Activity Log• Distribute CQI Activity Log Minutes

to all team members and scribe of the next level team within one week

• Maintain CQI Notebook with CQI Activity Logs in each office

• Train Scribe for next year

CQI, the PIP and COA Best Practice

CQI

PIP

COA

Focusing the CQI Process

Focus on specific data

elements each quarter

CQI quarterly focusing on

data element from PIP, COA

and other relevant data

PIP Improvement

CQI meetings

Local/state level solutions

developed

CQI Feedback

Questions?

Thanks for being a part of the solution!!!!