Building and Maintaining a Sustainable CQI Process
Transcript of Building and Maintaining a Sustainable CQI Process
Building and Maintaining a Building and Maintaining a Sustainable Sustainable CQI ProcessCQI Process
Peter Watson MPPPeter Watson MPPJerry Milner DSWJerry Milner DSW
Joan Nelson Phillips MSWJoan Nelson Phillips MSW
Workshop ObjectivesWorkshop Objectives
Through the workshop, participants will:Through the workshop, participants will:Understand some of the core CQI building Understand some of the core CQI building blocks for creating a sustainable systemblocks for creating a sustainable systemReview illustrative examples from Illinois Review illustrative examples from Illinois and other public child welfare systemsand other public child welfare systemsDevelop some ideas for moving forward Develop some ideas for moving forward with CQI in their own agencieswith CQI in their own agencies
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Illinois CQI Illinois CQI –– One StateOne State’’s s PerspectivePerspective
Implemented in 1997 Implemented in 1997 –– Still going strongStill going strongKey elements: Key elements: –– Active agency staff participation in Peer Record Review Active agency staff participation in Peer Record Review
and other review activitiesand other review activities–– Ongoing assessment of consumer satisfaction and risk Ongoing assessment of consumer satisfaction and risk
managementmanagement–– Use of evaluative data to support programmatic Use of evaluative data to support programmatic
improvementsimprovements
Key participants:Key participants:–– Agency Staff from all levels and divisionsAgency Staff from all levels and divisions–– Stakeholders Stakeholders –– foster parents, youth, private child foster parents, youth, private child
welfare agency providers, and birth parents via existing welfare agency providers, and birth parents via existing advisory councilsadvisory councils
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CQI Structural Components:CQI Structural Components:–– Regional, and Local field office QI Councils Regional, and Local field office QI Councils
that meet monthlythat meet monthly–– Statewide Quality Council that meets quarterlyStatewide Quality Council that meets quarterly–– Regional PIP workgroups (State agency and Regional PIP workgroups (State agency and
private child welfare providers) that meet private child welfare providers) that meet quarterlyquarterly
–– Use of tracking mechanisms that ensure Use of tracking mechanisms that ensure progress is made in achieving performance progress is made in achieving performance goalsgoals
Illinois CQI Illinois CQI –– One StateOne State’’s s PerspectivePerspective
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CQI in Illinois CQI in Illinois –– Evolving Evolving over Timeover Time
1997
Regio
nal C
QI
Coun
cils e
st.Pe
er R
eview
Imp.
1998
Loca
l CQI
team
s est.
Stat
ewide
CQI
Coun
cil e
st.
2000
2003 Illinois CFSR
What’s driving these changes???
OER
proc
ess I
mp.
Regi
onal P
IP
Wor
kgro
ups
est.
2004
Perf.
Con
tract
ing
data
intro
duce
d
to C
QI p
roce
ss
2007
???
2009
Changes in leadership & agency mission
Greater caseworker/supervisor involvement
Public/Private CW Agency Collaboration
Outcome (CFSR) focused problem solving
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CQI in Child WelfareCQI in Child WelfareA National PerspectiveA National Perspective
Changes in the Child Welfare communityChanges in the Child Welfare community’’s s commitment to CQI over the past decadecommitment to CQI over the past decade–– Focus on outcomesFocus on outcomes–– CFSR process and PIP focus on systemic changesCFSR process and PIP focus on systemic changes–– AccreditationAccreditation–– Lawsuits and settlement agreementsLawsuits and settlement agreements–– Increasing complexity of casework and human Increasing complexity of casework and human
service systemsservice systems
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CQI in Child WelfareCQI in Child WelfareA National PerspectiveA National Perspective
Key CQI functions:Key CQI functions:–– Identify data/information that are consistent with Identify data/information that are consistent with
agency mission & practiceagency mission & practice–– Gather data/informationGather data/information–– Analyze data/informationAnalyze data/information–– USE results to bring about change!USE results to bring about change!
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One Potential CQI ModelOne Potential CQI Model
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PracticePractice
Making CQI SustainableMaking CQI Sustainable
Connect CQI to the bigger picture of what Connect CQI to the bigger picture of what your agency is trying to accomplishyour agency is trying to accomplish–– Organize case practice around mission, vision Organize case practice around mission, vision
and valuesand values–– Support agency leadership priorities through CQISupport agency leadership priorities through CQI–– Assess CQI processes for relevance to the Assess CQI processes for relevance to the ““big big
picturepicture”” & eliminate those not targeted& eliminate those not targeted–– Integrate CQI with other key systems (e.g., Integrate CQI with other key systems (e.g.,
Training, HR, Service Array)Training, HR, Service Array)
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Making CQI SustainableMaking CQI Sustainable
Management investment/leadership in the Management investment/leadership in the CQI process is criticalCQI process is critical–– Management must lead by example to ensure Management must lead by example to ensure
““buybuy--inin””–– Sometimes a topSometimes a top--down approach helps to down approach helps to
reemphasize central themes and programmatic reemphasize central themes and programmatic performance goalsperformance goals
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Making CQI SustainableMaking CQI Sustainable
CQI must be grounded in a strong, CQI must be grounded in a strong, broader model of QA in an agencybroader model of QA in an agency–– Need access to reliable data and informationNeed access to reliable data and information–– Need to have solid accountability standardsNeed to have solid accountability standards–– Need for a Need for a ““quality continuumquality continuum”” –– some some
compliance monitoring still may be criticalcompliance monitoring still may be critical–– Should reinforce and help sustain practices Should reinforce and help sustain practices
over time that support improved outcomesover time that support improved outcomes
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Making CQI SustainableMaking CQI Sustainable
There must be a clear vision and explicit plan There must be a clear vision and explicit plan for CQIfor CQI–– Have longHave long--term goals for CQI that are linked to term goals for CQI that are linked to
agency vision and to practiceagency vision and to practice–– Also have flexible, shortAlso have flexible, short--term strategiesterm strategies–– What needs to measured, monitored, reinforced?What needs to measured, monitored, reinforced?
Create a solid CQI organizational structure Create a solid CQI organizational structure (your CQI (your CQI ““househouse””) and be prepared to ) and be prepared to modify it over timemodify it over time
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Decisions Decisions Decisions…
What type of structure does your agency CQI model need?(Hint: One size does NOT fit all!)
Your roof?
Walls/Structure?
What do you put in first?
Foun
datio
n?
The Illinois CQI House 2002
Local Quality Teams
RQCC/N
RQCNorthern
StatewideQuality Council
RQCCentral
RQCC/C
RQCSouthern
RQCC/S
SQC SQC
SQC
SQC SQC SQC SQC SQC SQC SQC SQC SQC SQC SQC SQC
SQC SQC SQC
SQC SQC
SQC
SQC SQC
SQC
SQC
SQC SQC SQC SQC
SQC SQC SQC
SQC
Your roof?
Walls/Structure?
What do you put in first?
Foun
datio
n?
Illinois DCFS CQI Structure
Statewide Quality Council
DCFS Regional Quality Councils
Site Clusters
Local QI Teams
Statewide PIP Committee
Regional PIP Workgroups
Statewide POS Quality Council
POS Regional Quality Councils
Individual POS agency internal QA/QI Systems
DCFS
The Illinois CQI Compound2009
DCFS & POS POS
Stakeholder Advisory Councils
Making CQI SustainableMaking CQI Sustainable
Consider existing organizational structures Consider existing organizational structures and resourcesand resources–– Use data and information from a variety of Use data and information from a variety of
sourcessources–– Remember the goal is to provide targeted Remember the goal is to provide targeted
information and use it to make improvements information and use it to make improvements (not just to sustain multiple processes (not just to sustain multiple processes indefinitely)indefinitely)
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Making CQI SustainableMaking CQI Sustainable
Plan to invest in infrastructure to support Plan to invest in infrastructure to support CQI (itCQI (it’’s necessary and worth it!)s necessary and worth it!)–– YouYou’’ll need sufficient staff to support the CQI ll need sufficient staff to support the CQI
processprocess–– Training (initial and ongoing) for CQI staffTraining (initial and ongoing) for CQI staff
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Making CQI SustainableMaking CQI Sustainable
Provide responsive, understandable and Provide responsive, understandable and targeted CQI reports:targeted CQI reports:–– Too many systems produce an overabundance Too many systems produce an overabundance
of data and informationof data and information–– Narrow CQI reports to focus on core practices Narrow CQI reports to focus on core practices
and critical outcomesand critical outcomes–– Use CQI staff to support the understanding Use CQI staff to support the understanding
and use of data/reports throughout your and use of data/reports throughout your organizationorganization
–– Remember Remember -- Be flexible!Be flexible!
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Engage staff and stakeholders in the CQI Engage staff and stakeholders in the CQI process and build genuine support in your process and build genuine support in your agency over timeagency over timeStaff are generally more invested in using Staff are generally more invested in using information they themselves helped to gatherinformation they themselves helped to gatherCQI Committees need to be tasked with CQI Committees need to be tasked with using data/results to actually generate using data/results to actually generate programmatic improvementsprogrammatic improvements
Putting Down CQI Putting Down CQI Roots Roots –– it takes time it takes time ……
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Be prepared to also address/resolve basic Be prepared to also address/resolve basic aspects of day to day work through CQIaspects of day to day work through CQISustainability = Growth: Provide Sustainability = Growth: Provide opportunities for those invested in your opportunities for those invested in your CQI process to become active in other CQI process to become active in other professional review activities (e.g. COA, professional review activities (e.g. COA, CFSR)CFSR)
Putting Down CQI Putting Down CQI Roots Roots –– it takes time it takes time ……
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I have so much enjoyed working with the QI Process I have so much enjoyed working with the QI Process over the years. We have accomplished much and have over the years. We have accomplished much and have come so far. Way backcome so far. Way back……we embarked on a wonderful we embarked on a wonderful journey together.journey together. That Summit brought all of us, That Summit brought all of us, workers and management, together at the table workers and management, together at the table discussing how to improve our work and how to do it discussing how to improve our work and how to do it together. I will never forget the exhilaration that I felt together. I will never forget the exhilaration that I felt after those two days together. We have worked to build after those two days together. We have worked to build the the ““House of QIHouse of QI””. We have a wonderfully sound . We have a wonderfully sound foundation, and have moved forward with new projects.foundation, and have moved forward with new projects.
Email message from retiring Illinois caseworker, 2009Email message from retiring Illinois caseworker, 2009
Putting Down CQI Putting Down CQI Roots Roots –– it takes time it takes time ……
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Getting Started Getting Started ……
Is your CQI system connected to the Is your CQI system connected to the agencyagency’’s bigger picture and goals?s bigger picture and goals?Is your leadership invested in CQI?Is your leadership invested in CQI?Do you have a strong, broad QA model?Do you have a strong, broad QA model?Do you have a clear and explicit CQI plan?Do you have a clear and explicit CQI plan?
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Getting Started Getting Started ……
Does your CQI organizational structure Does your CQI organizational structure support your goals and overall plan?support your goals and overall plan?Do you have sufficient CQI infrastructure?Do you have sufficient CQI infrastructure?Does your CQI system provide responsive, Does your CQI system provide responsive, understandable and targeted reports?understandable and targeted reports?How are staff and stakeholders involved in How are staff and stakeholders involved in your CQI system?your CQI system?
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Contact InformationContact InformationPeter WatsonPeter Watson207207--228228--8330 (office) 2078330 (office) 207--632632--0892 (mobile)0892 (mobile)[email protected]@usm.maine.edu
Jerry MilnerJerry [email protected]@csfmail.org
Joan NelsonJoan Nelson--PhillipsPhillips312312--814814--5527 5527 [email protected]@illinois.gov
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