521: fall 2013: supervisor training event: supporting your staff in the quality service review...

521: Fall 2013: Supervisor Training Event: Supporting Your Staff in the Quality Service Review Process

521: Supervisor Training Event: Supporting Your Staff in the Quality Service Review Process

The Pennsylvania Child Welfare Resource Center

Learning Objectives

Participants will be able to:

Recognize the relationship between child welfare outcomes, CQI, The Pennsylvania Child Welfare Practice Model, and the QSR Process;

Identify the components of the QSR process;

Apply the use of critical thinking questions to support practice model implementation during supervisory conferences; and

Identify ways to support staff before, during, and after a QSR.

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Agenda

• Welcome and Introductions• What is the QSR?• QSR Process Overview• Supporting Staff Long Before a QSR• Child/Family Status Indicators• Practice Performance Indicators• Panel Discussion• Panel Discussion Q&A• Transfer of Learning: Your Next Unit Meeting

Agenda • Summary and Workshop Closure

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OutcomesSafety, Permanence, and Well-being

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CQI

CQI is not a time-limited initiative or project.

CQI is the ongoing process by which an agency makes decisions and evaluates progress.”

National Child Welfare Resource Center for Organizational Improvement and Casey

Family Programs, 2005.

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Pennsylvania’s Child Welfare Practice Model

Linking Idealsto

Practice

Vision & Values

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What is a “Practice Model”?

At its most basic level, a child welfare practice model is a conceptual map and organizational ideology of how (child welfare professionals), families, and stakeholders should unite in creating a physical and emotional environment that focuses on the safety, permanency, and well-being of children, youth and their families.

© 2009 APHSA

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http://www.google.com/url?sa=i&rct=j&q=road+map&source=images&cd=&cad=rja&docid=ZSc_9UL2svGr1M&tbnid=LNNA0a8aoIdinM:&ved=0CAUQjRw&url=http://wiki.scalr.com/display/docs/Roadmap&ei=sJQ_UbXTJq2o0AGfg4GgBg&bvm=bv.43287494,d.dmQ&psig=AFQjCNF-_uOIPkCWfjnog4kvhniQFcpxEg&ust=1363207716409477



What is a “Practice Model”? (continued)

The practice model should make an explicit link connecting the (child welfare system’s) policy, practice, training, supervision, and quality improvement with its mission, vision, agency values, and strategic plan. It is the (system’s) guide to the daily interactions among employees, children, youth, families, stakeholders, and community partners working together to achieve defined outcomes.

© 2009 APHSA

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The Quality Service Review (QSR) Process

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Why QSRs and Why Now?

Outcomes for Children, Youth, and Families

Continuous Quality Improvement (CQI)

Practice Model

QSR Process

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Purposes of the QSR Process

• To appraise the current status of the focus child/youth and family and the performance of key practice areas;

• To assure that the actions of a team of child welfare professionals are guided by clear and comprehensive policies and are rooted in Pennsylvania’s Child Welfare Practice Model/Standards;

• To improve the quality and usefulness of information needed to evaluate the safety, permanence and well-being of children and youth; 11



Purposes of the QSR Process (Continued)

• To assure the quality and effectiveness of services for children, youth, and families by regularly reviewing programs and practices;

• To support the efforts of child welfare agencies to maintain an environment that encourages learning and program improvement; and

• To stimulate actions and next steps, to build on strengths and support efforts to improve outcomes.

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What is the QSR?

The QSR is designed to conduct an in depth review of front line practice in specific locations and points in time.

It is used for:

• Appraising the current status of a child/youth in key life areas;

• Appraising the current status of the parent/caregiver; and

• Appraising the performance of key practices for the same child/youth/family.

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How is the QSR Different from Other Quality Assurance Methods?Traditional Review Were visits timely?

Is the child’s IEP inthe file?

Was there a referralto mental health?

Quality Service Review

Are children currentlysafe?

Is the child progressing well academically?

Is the child functioning well emotionally?

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How is the QSR Different from Other Quality Assurance Methods? (Continued)

Traditional Review

Is there a current plan in the file?

Did the parents sign the plan?

Is there a written assessment?

Quality Service Review

Is the plan likely to lead to permanence?

Do the parents feel that the plan is their own?

Does the assessment accurately identify underlying needs?

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Don’t Let Action Items Get Away!

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Steps in the QSR Process

1. Review Team Pairings2. Sample Selection3. Focus Groups and Stakeholder Interviews4. Case Reviews5. Feedback Session with the

Caseworker/Supervisor6. Case-Specific Debriefing7. QSR Written Case Review Summary8. Exit Conference 9. Final Report10.Next Steps Meeting11.County Improvement Plan

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What Happens Prior to the Onsite Review?• Identification and pairing of internal and

external reviewers;

• Random sample of a county’s cases are selected and stratified by a service area;

• Family permission obtained to participate in the review and consents/releases obtained; and

• Key interviews in each case are identified and appointments are scheduled.

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Focus Groups and Stakeholder Interviews

Purpose:– Obtain feedback specific to systemic

issues rather than case-specific information; and

– Provide a forum for open dialogue about

challenges and solutions within the system.

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Focus Groups and Stakeholder Interviews

Invited to…

Focus Groups:• Caseworkers, Supervisors, Managers, Service

Providers, and Resource Parents

Stakeholder Interviews:• Judges, Attorneys, Police, Probation Officers,

County Commissioners, etc.

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Exit Conference – What Happens?

• A few reviewers may be asked to present the highlights from their case review.

• The Local and State Site Leads deliver the aggregate findings from all the cases reviewed along with trends discovered from the focus groups and stakeholder interviews.

• Key strengths and areas needing improvement are identified.

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Final Report – What Happens?

• Final Report which includes analysis of demographic information, quantitative analysis of indicator scores, and information from the County Specific Data Packet is shared.

• The county will use the data and analysis to develop a County Improvement Plan.

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Next Steps Meeting – What Happens?

• Approximately 6-8 weeks after the onsite review;

• Led by the Local and State Site Leads;

• Lasts approximately two hours;

• Discuss the recommendations for next steps in working toward an action plan for improving frontline practice and system performance; and

• Begins the next step in the CQI process.23



Were You Involved in Any of These Steps?

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Child/Youth and Family Status Indicators

• Safety: Exposure to Threats of Harm;• Safety: Risk to Self/Others;• Stability;• Living Arrangement;• Permanency;• Physical Health;• Emotional Well-Being;• Early Learning and Development;• Academic Status;• Pathway to Independence; and• Parent or Caregiver Functioning.

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Practice Performance Indicators• Engagement Efforts;• Role and Voice;• Teaming;• Cultural Awareness and Responsiveness;• Assessment and Understanding;• Long-Term View;• Child/Youth and Family Planning Process;• Planning for Transitions and Life Adjustments;• Efforts to Timely Permanence;• Intervention Adequacy and Resource Availability;• Maintaining Family Relationships; and• Tracking and Adjusting.

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What Time Period is Considered in Scoring?• Child/Youth and Family Status Indicators

look at the past 30 days– Exceptions are: Stability and Academic Status

• Practice Performance Status Indicators look at the past 90 days– Exceptions are: Planning for Transitions and Life

Adjustments and Efforts to Timely Permanence

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How are Cases Scored?

Each indicator is scored on a scale of 1 – 6• 6 – Optimal• 5 – Substantial Acceptable Range• 4 – Fair• 3 – Marginal• 2 – Poor Unacceptable Range• 1 – Adverse

Maintenance Zone: 6-5Refinement Zone: 4-3

Improvement Zone: 2-1

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Critical Thinking Defined

Seeing both sides of an issue, being open to new evidence that disconfirms your ideas, reasoning dispassionately, demanding that claims be backed by evidence, deducing and inferring conclusions based on available facts (and) solving problems.

(Willingham, 2008).

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• Description of Family/Current Status

• Perspective of the Team

• Worker Analysis

• Evaluation

• Decisions and Next Steps

Tasks of Critical Thinkers

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Three Ways to Use the Guide

• Worker need

• Department/unit focus area

• Supervisory skill development

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Child/Youth and Family Indicators Pair Activity1. With your partner, review the sections of

Handouts #5 and Handout #6 pertaining to your assigned indicators and discuss with your partner.

2. Read Handout #7.

3. With your partner, develop two good questions for each assigned indicator that you could ask your worker during supervision to help you assess how well he/she has implemented the practice model.

4. Be prepared to join other teams in a group discussion. 34



Child/Youth and Family Indicators Large Group Activity

1. Explain the indicator.

2. Share two good questions that you could ask a caseworker to gather information surrounding your indicator.

3. Join other pairs in a group discussion about the supervision experience.

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Practice Performance Indicators Pairs Activity1. With your partner, review and discuss sections

of Handouts #5 and Handout #6 pertaining to your assigned indicators.

2. With your partner, develop two good questions for each assigned indicator that you could ask your worker during supervision to help you assess how well he/she has implemented the practice model with the Gorman Family.

3. Be prepared to join other teams in a group discussion.

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Practice Performance Indicators Large Group Activity

1. Explain the indicator.

2. Share two good questions that you could ask a caseworker to gather information surrounding your indicator.

3. Join other pairs in a group discussion about the supervision experience.

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Panel Discussion

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You Must Have Questions!

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CQI Continues…

Remember QSR is NOT a one-time event. It’s part of the bigger CQI process that leads to

improved outcomes of Safety, Permanence, and Well-Being for children, youth and families.

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521: fall 2013: supervisor training event: supporting your staff in the quality service review...

Documents

child welfare outcomes

child welfare professionals

supervisor training

child welfare systems

ongoing process

qsr process overview

quality improvement

practice model implementation