Using MiTEAM and PITA in the Continuous Quality Improvement Process

1. Using MiTEAM and PITA in the Continuous Quality Improvement Process Michigan Department of Health & Human Services Heather Samkowiak DHHS Business Service Center 1 Natalie Riddle DHHS Children’s Services Administration, Division of Continuous Quality Improvement Putting people first, with the goal of helping all Michiganders lead healthier and more productive lives, no matter their stage in life.

3. Why do it? • Historically we have reacted to audit findings • CQI allows us to be proactive where we are using real-time data to inform intentional decisions that improve practice and outcomes for families • Identify and communicate areas of systemic strengths and growth opportunities • Support the development of strategies to improve areas of performance • Provide ongoing evaluation, assessment and management of the strategies designed and undertaken to improve services and outcomes for children and families • Improve and increase the accuracy of data collection, verification and analysis

4. Quality Assurance vs. Quality Improvement Quality Improvement • Continuously improving processes to establish best practice • Focuses on engagement of children and families/staff/ communities to identify shared values and needs • Emphasizes prevention, ongoing evaluation and outcomes over time • Intentional actions to provide safety and build resilience • Small tests to determine if changes are successful prior to, during, and after implementation Quality Assurance • Measures compliance with standards/policies • Focuses on compliance

5. Integration of MiTEAM with CFSR and QSR Child and Family Status Indicators 1. Safety from Exposure 2. Behavioral Risks to Self or Others 3. Stability 4. Permanency 5. Living Arrangement 6. Physical Health 7. Emotional Functioning 8a. Early Learning and Development 8b. Academic Success 8c. Preparation for Adulthood 8d. Transition to Adulthood 9. Voice and Choice 10. Family Functioning & Resourceful 11a. Caregiving Functioning (family setting) 11b. Residential Care (group setting) 12. Family Connections Practice Performance Indicators (QSR) 1. Responsiveness to Culture Identity and Need 2. Engagement 3. Teaming 4. Assessment and Understanding 5. Long-Term View 6. Planning Interventions 7. Implementing Interventions 8. Tracking and Adjustment MITEAM Competencies 1. Engagement 2. Assessment 3. Teaming 4. Case Planning 5. Placement Planning 6. Case Plan Implementation 7. Mentoring

6. DATA vs EVIDENCE DATA Data is facts and statistics collected together for reference or analysis EVIDENCE It is information used to support an observation, claim, decision, hypothesis or problem. Evidence can be qualitative or quantitative

7. Available Resources* BOB Data warehouse/ InfoView Monthly Management Reports AdHoc Requests Internal spreadsheets Observations U of M Data Lab Kids Count CFSR Dashboard Fidelity Tool results Case read forms • ISEP Review Tools • Targeted case read forms CRT Read Results Peer Reviews QSR: BSC/County Reports Focus Groups/Interviews MIC Excel tracking Existing Findings CFSR PIP , CPS Audit, ISEP, Local CQI Plan * The above list of tools and templates are only examples. There are many other resources that can be utilized and/or developed by you and your CQI team.

8. CQI REQUIRES TEAMWORK

9. TAKING ACTION • Plan Identify the goal and outcome. Collect baseline performance. Assess current approach. Brainstorm potential solutions. Design intervention/develop plan • Implement Apply the intervention. Complete action steps identified in the plan. • Track Measure the performance outcome and assess results. Determine impact of intervention Assess implementation • Adjust Adjust intervention as needed. Standardize the intervention or develop a new intervention. Establish future plans. Start cycle over as needed for new interventions.

10. MOCK CQI DEMONSTRATION PLAN Subject to Assess: Relative Placements Data Analysis: Collecting baseline data – Interpret Findings (Data mine/case reads/other data) Root Cause: Safety of Relative Placement Hypothesis: Improving the perception of relative placements (“not appropriate because they can’t be licensed”). Improving worker assessment skills: accurate, consistent and timely completion of the 588/3130-A. Lack of resources available for relatives.

11. MOCK CQI PLAN TEMPLATE

12. Mock CQI Demonstration cont. IMPLEMENT • Action: Statewide Training in Local offices Ongoing case reviews Establishing local office protocols Pilot Program Policy Changes Form revision

13. MOCK CQI PLAN TEMPLATE

14. MOCK CQI PLAN TEMPLATE

15. Mock CQI Demonstration cont. TRACK • Utilize the same method for collecting evidence so you can compare • 6.10 588 and 3130a reads • Relative Assessment Screening Tool • Did we achieve the desired outcome?

16. MOCK CQI PLAN TEMPLATE

17. Mock CQI Demonstration cont. ADJUST Did we achieve our desired outcome?

18. QUESTIONS?

19. Bibliography • Welfare. Casey Family Programs. Retrieved June 3, 2019, from https://caseyfamilypro-wpengine.netdna-ssl.com/media/Considerations-for-Applying-Predictive-Analytics-in-Child-Welfare.pdf • Using Continuous Quality Improvement to Improve Child Welfare Practice – A Framework for Implementation. Casey Family Programs and the National Child Welfare Resource Center for Organizational Improvement. May 17, 2005. Retrieved June 3, 2019, from https://muskie.usm.maine.edu/helpkids/rcpdfs/CQIFramework.pdf • MiTEAM Practice Model Manual. Michigan Department of Health and Human Services Children’s Services Administration. Revised May 2016. Retrieved June 11, 2019, from https://www.michigan.gov/documents/mdhhs/MiTEAM_Practice_Model_Manual_535451_7.pdf • MiTEAM Virtual Learning Site https://miteam-vls.michigan.gov/cqi