1 Quality Improvement and Performance Measurement in Social Services in Israel Tamar Zemach-Marom June 2011.

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Quality Improvement and Quality Improvement and Performance Performance

Measurement in Social Measurement in Social Services in IsraelServices in Israel

Quality Improvement and Quality Improvement and Performance Performance

Measurement in Social Measurement in Social Services in IsraelServices in Israel

Tamar Zemach-MaromTamar Zemach-Marom

June 2011June 2011

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Main Goals of the RAF Method

1. Monitor adherence to the standards and regulations

2. Encourage continuous improvement at all levels

3. Enhance management capacities of the care facilities

4. Provide database for policy making

Residential settings for:•The aged•Children at risk•Juvenile offenders•Physically disabled•Developmentally disabled•People struggling with alcohol, drug and gambling addictions

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Services Utilizing the RAF Method

Services in the community:•All community services for children and youth at risk•Rehabilitative preschool facilities for disabled children•Service for treatment of addictions•Social Service departments at the municipalities

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Prior to RAF:

The regulatory process: not systematic and not uniform

Hardly any written documentation for inspection and care

facilities

No systematic data collection

Inspectors serving mainly as advisors

Multi-Annual Inspection, according to the RAF Method

7. Decisions about licensing the facility7. Decisions about licensing the facility

1. Collecting client data1. Collecting client data

2. Analyzing client data and producing reports

2. Analyzing client data and producing reports

3. Constructing personal care plans3. Constructing personal care plans

4. Collecting additional data4. Collecting additional data

5. Constructing a yearly work plan5. Constructing a yearly work plan

6. Internal quality assurance processes6. Internal quality assurance processes

Year without Comprehensive Inspection Year without Comprehensive Inspection ProcessProcess

Year without Comprehensive Inspection Year without Comprehensive Inspection ProcessProcess

Regular inspector visits

Regular inspector visits

Regular inspector visits

Regular inspector visits

Regular inspector visits

Regular inspector visits

4. Collecting additional data4. Collecting additional data

7. Decisions about licensing the facility7. Decisions about licensing the facility

1. Collecting client data1. Collecting client data

2. Analyzing client data and producing reports

2. Analyzing client data and producing reports

3. Constructing personal care plans3. Constructing personal care plans

6. Internal quality assurance processes6. Internal quality assurance processes

5. Comprehensive inspection process

Year of Comprehensive Inspection Year of Comprehensive Inspection ProcessProcess

Year of Comprehensive Inspection Year of Comprehensive Inspection ProcessProcess

Index:Inspection processesProcesses at the facility

Initial follow-up

Regular inspector visits

Regular inspector visits

Regular inspector visits

Regular inspector visits

Regular inspector visits

Regular inspector visits

Feedback to the facility & constructing a yearly work plan

Comprehensive visit

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Types of Data Provided by the RAF SystemTypes of Data Provided by the RAF System

1. Data on clients Demographic and administrative data Profile of their problems (tracers)

2. Data on quality of care in the facilities, regarding:

Treatment Management Infrastructure Client's perspective

3. Information on implementing inspection

Meeting work plan requirements

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The Impact of the RAF: The Inspection Level

1. Creating uniform and systematic tools for

inspection

2. Streamlining the process of regulation

3. Transparency and improved dialogue with the care

facility

4. Incorporating the client viewpoint as part of the

regulation process

5. Decisions based on data

6. Help in dealing with irregular incidents

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The Impact of the RAF: The Level of the Care Facility

1. An enhanced sense of fairness

2. Improved service

3. Improved record keeping

4. More structured work procedures

5. Triggering organizational learning processes and

data-based decision making

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The Impact of the RAF: The Service Management Level

1. Data-based policymaking

2. Upgrading standards and regulations

3. Creating a common language and basis for

comparison

4. A solid base for steps of enforcement

5. Improving the ability to monitor the regulation

process

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Contributing Factors for Successful Implementation

1. Awareness and motivation to change

2. Commitment of the leadership

3. True partnership between people in the field and

the advisory body

4. Gradual implementation

5. Providing resources and infrastructure

6. Using opinion leaders to serve as agents of change

7. Flexibility

8. Presenting data in a user friendly way9. Immediate response to obstacles

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Thank You

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The Ministry of Social AffairsThe Ministry of Social AffairsThe RAF SystemThe RAF System

The Children and Youth ServicesThe Children and Youth Services

I.D. Family

Name

First Name

GenderAge1234567891011121314

M10

M10

M9

F10

F9

M7

M10

M11

M13

F10

F11

F10

List of Tracers

1. Low achievement at school

3. Running away

5. Problematic relations with family

7. Problematic social behavior

9. Enuresis11. Drug abuse13. Suicidal behavior

2. Behavior at school

4. Physical self-neglect

6. Aggression8. Theft10. Alcohol use12. Depression and anxiety

14. Problematic sexual behavior

No problem

Having no difficulty with tracer

Difficulty with tracer – no change from the previous year

Difficulty with tracer in previous year – improvement noted this year

Sample ReportSample Report