The Continuous Quality Improvement Process

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

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CQI Supports our Guiding Principles

• Protection
• Permanency
• Partnership
• Practice
• Prevention
• Professionalism

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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

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Components of the CQI System
Outcome Reports
Consumer Surveys
Management Reports
CQI Process
Staff Surveys
Peer Record Reviews (PRR)
Program Development Reviews (PDR)
Grievance Data
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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

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Monthly Management Reports (Pink Books)

• Monthly publication available on the intranet
• regarding
• - CA/N
• - FCS
• - FCOOHC
• - IIHS

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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 reviewers
  knowledge and skills are enhanced
• 10 of CA/N, FCS, and FCOOHC cases are reviewed

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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

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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

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Consumer Surveys

• Random sample of Surveys generated from Research
  and Evaluation and sent to
• Active youth in care
• Adults served in active FCS
• Adults served in IIS
• Adults recently involved in CA/N report
• Active Foster/Relative care providers

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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

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CQI Meetings

• Underlying Principles
• Purpose
• Agendas
• Team Roles
• Meeting Focus

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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

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Purpose of CQI Meetings
Non-Purposeof 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

• 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 Ill wait it
  out and it will go away

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CQI Meeting Agendas

• Any Service Delivery Issue
• Have an agenda
• 90 minutes every quarter
• Review of In Focus CQI Newsletter
• Examination of Program Evaluation Data (PRR,
  Outcome Reports etc)
• Review of past issues
• Updates on new projects
• Reviews of incidents, accidents, grievances

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CQI Meeting Activity Log Location
(Office/County/Circuit/Region/State Office)
Date
Participants
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
Summary of Data Reviewed
Issues/ Concerns What Are We Going To Do? By Whom Due Date Desired Outcome



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TEAM MEMBER ROLES

• Leader
• Facilitator
• Scribe

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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

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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

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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

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CQI, the PIP and COA Best Practice
COA
CQI
PIP
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Focusing the CQI Process
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Questions?
Thanks for being a part of the solution!!!!