Strengthening Service Quality © The Quality Service Review Institute, a Division of the Child...

Strengthening Service Quality © The Quality Service Review Institute, a Division of the Child Welfare Policy & Practice Group, 2014

Strengthening Service Quality To Improve Results

Using Measures of Service Quality

To Affirm Good Results Today and

Achieve Even Better Outcomes Tomorrow

What is Quality?What does Quality mean to you – as it relates

to your service experiences?

How should we define Quality – related to your services and service outcomes?

How do we measure Quality now– related to your services and service outcomes?

How do we use what we learn about Quality -- to improve our services & outcomes?


Perspectives on QualityA Person’s Perspective

Meeting my needs, hopes, goals, and expectations

Having good relationships and positive experiences

Receiving helpful services

Getting better, doing better, and staying better

A Program’s Perspective

Fulfilling the social purposes (mission) of the program

Passing the next audit

Doing good practice

Providing good care

Getting good outcomes


What are Outcomes?• PURPOSE -- Helping a person having major life needs for care,

treatment, assistance, support, and/or protection to achieve and maintain adequate levels of: [OUTCOMES => THRIVING]

– Well-Being (safety, stability, health, mental health, positive relationships)

– Supports for Living (housing, income, health care, transportation, and supports for daily living and, where necessary, supports for caregivers)

– Daily Functioning (performing tasks necessary for successful daily living and socializing in community settings and activities)

– Fulfillment of Key Life Roles (capacities and supports for being a friend, family member, tenant, and citizen)


Desired Qualities of Practice & Care*


* These Qualities should be Evident in Practice for Each Person Served

9TEAMING

To Unify Efforts &COORDINATING

Interventions

Practices Supporting Good Care

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5 6

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ENGAGING the Person, Informal Supporters,

Interveners

ASSESSING Strengths, Needs, Aspirations, Risks,

Underlying Issues

PLANNING Outcomes, Intervention Strategies, Actions, Assignments

RESOURCING Planned Intervention Strategies, Actions, and Supports

INTERVENING by Delivering Planned Strategies, Supports

and Making Transitions

TRACKING Progress, Results, What’s Working; Maintaining Situational

Awareness

ADAPTING Services Through On-going Assessment and

Planning

ELIGIBLE PERSON => SYSTEM ENTRY

MEETING OUTCOMES, DISCHARGE REQMTS, STEP-DOWN => EXIT

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CLINICAL REASONING: Understanding What Must Change & How

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Questions

How to Measure Quality?

How to Use What is Learned to Improve Care Practices & Services?



Your VANTAGE POINTDetermines What You SEE

Chart Audit =15-degree

“KEY HOLE”View focused on a

Record-Based COMPLIANCE CHECKLIST

Quality Review = 360-degree

“BIG PICTURE”View focused on Person-Centered

PRACTICE & RESULTS

Program Compliance Results for People

What is a Quality Service Review?

QSR is an ORGANIZATIONAL LEARNING PROCESS.

QSR observes the PRACTICE & CARE being provided.

QSR connects results to local FRONTLINE CONDITIONS.

QSR supports TEACHING & LEARNING PROCESSES that clarify expectations, provide useful feedback, affirm good work.

QSR stimulates NEXT STEP ACTIONS taken to improve practice, services, and results at all levels of the organization.


What is the QSR Designed to Measure & Improve?

* QSR reveals the extent to which the Business Model supports the Practice required for the Person Served


How Providers Should Perceive QSR Experiences


A QSR Protocol• Functions as a GUIDE BOOK for focusing reviews• Provides qualitative indicators with fact patterns• Provides rating scales for indicators• Sets time windows for reviewing• Provides a BASIS for the:

– DATA PROFILE or “roll-up sheet”– ORAL REPORT made a debriefing– WRITTEN REPORT of findings– NEXT STEP PLANNING


What Status & Progress Indicators Measure

• Safety from harm by others• Behavioral risk• Income adequacy & control• Living arrangement• Social network• Physical well-being• Emotional well-being• Functional life skills (ADLs)• Productive / contributory activities• Social integration /community• Caregiver capacity & support• Voice & choice in decisions• OVERALL PERSON STATUS

Status Indicators

• Improved social integration

• Reduction in safety / health concerns

• Reduction in life disruptions

• Progress toward life goals

• GENERAL PROGRESS PATTERN

Progress Indicators


• Engagement (trust-based working relationships)

• Teamwork & coordination• Assessing & understanding• Setting personal goals• Planning strategies & supports

for:• Personal goal attainment• Advance care direction / estate mgt• Income & basic necessities• Supports for daily living• Social integration / leisure activities• Productive / contributory activities• Managing chronic health concerns• Other interventions

• Implementing interventions• Medication management• Transitions & life adjustments • Status tracking & plan adjustment• OVERALL PRACTICE

PERFORMANCE

What Practice Performance Indicators Measure


What You Get from QSR


Powerful Person-Based Teaching Stories

Respectful & HelpfulFeedback for Staff

Performance ResultsFor Practice Indicators

Understanding of Local Practice Conditions & Patterns

Next Step Action Planning

Better ServicesAnd Results

An Individual’s Profile

Selected QSR Results for a Person Named Robert


QSR Profile for Robert


A Group Profile

QSR Results for a Group of PersonsBeing Served at a Provider Site


QSR Profile for a Group



How QSR is UsedStrategic Tool of Leadership for stimulating improvement

Helping leaders understand and improve the quality of practice and services

Training, mentoring, and coaching of frontline practice

Measuring Change for affirmation, instruction, and direction

Guiding organizational development

Becoming the best practitioners that we can be

A Path to Better Results

Excellence is never an accident.

It is always the result of high intention, determined effort, and

skilled execution.

- Chinese Proverb -Strengthening Service Quality © The Quality Service Review Institute, a Division of the Child Welfare Policy & Practice Group, 2014

Strengthening Service Quality © The Quality Service Review Institute, a Division of the Child...

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