The Continuous Quality Improvement Process

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

2. 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 Missouri’s children.

3. CQI Supports our Guiding Principles Protection Permanency Partnership Practice Prevention Professionalism

4. 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

5. 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

6. 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

7. Monthly Management Reports (Pink Books) Monthly publication available on the intranet regarding: - CA/N - FCS - FCOOHC - IIHS

8. 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 reviewer’s knowledge and skills are enhanced • 10% of CA/N, FCS, and FCOOHC cases are reviewed

9. 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

10. 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

11. 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

12. 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

13. CQI Meetings • Underlying Principles • Purpose • Agendas • Team Roles • Meeting Focus

14. 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 1st Level 2nd Level 3rd Level State Underlying Assumptions of CQI

15. 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 – I’ll wait it out and it will go away”

16. 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

17. 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:

19. TEAM MEMBER ROLES • Leader • Facilitator • Scribe

20. 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

21. 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

22. 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

23. CQI, the PIP and COA Best Practice COA CQI PIP

24. Focusing the CQI Process

25. Questions? Thanks for being a part of the solution!!!!