CQI at Franklin County Children Services

1. CQI at Franklin County Children Services Metro Presentation August 15, 2014 Julia Harrison & Linda Peters

2. Important Foundations • 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 • CQIPlan: • 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

3. CQI Drivers • 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

4. CQI is Agency-wide • Orientation- CQI introduction for all new employees, personal commitment • Committees are key • “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 activities- learning environment

5. FCCS Committees a. Best Practice Council Committee j. Executive Council b. Board and Administrative Policies Committee k. Green Space Committee c. C3 (COA, CPOE, CFSR) Committee l. Information & Technology d. Chairs’ Cabinet (IT) Review Panel e. Child Risk Review Committee m. Multi-Cultural Development • Child Death Review Panel n. Risk Management Committee f. Clerical Committee o. Safety Committee g. Committee Communications Council p. Speaker’s Bureau h. Continuous Quality Improvement (CQI) q. Supportive Work Environment • i. CQI Short Term Plan (STP) Workgroups i. Employee Handbook Committee

6. PIE Support- Evaluation • 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

7. PIE Support – Performance Improvement (PID) • 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

8. PID and Peer Review • 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

9. FCCS “True” Peer Review • 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!

10. FCCS Steps in Peer Review 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

11. PLANNING for Peer Review • 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

12. IMPLEMENTATION with Peer Review • 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!

13. EVALUATION with Peer Review • 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

14. Next STEPS with Peer Review • 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 improvements- process, clarification of policies/guides, Q-tips, training/education, measuring/monitoring with reports • Sustain—through accountable processes, use data, SACWIS, reports & monitoring, FCCS Dashboard

15. Peer Review Highlight-CAPMIS Reunification Assessments (RAs) • 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.

16. Reunification Assessment Timeliness

17. Reunification Assessment Quality

18. 2013 Peer Review Satisfaction Survey