Fostering Local and National Collaboration to Support Continuous Quality Improvement Angela Sheehan, ORC Macro Beth Dague, Project Director, Project Tapestry.

Fostering Local and National Collaboration to Support Continuous

Quality Improvement

Angela Sheehan, ORC MacroBeth Dague, Project Director, Project Tapestry

Chris Stormann, Evaluator, Project TapestryTeresa King, Family Lead, Project Tapestry

Local and National Collaboration

What is Continuous Quality Improvement (CQI)?

CQI Key Principles

“It is because of these data that we can say systems of care work’” – Gary Blau, May 2006

Systems of Care CQI Framework

Monitoring Progress:Evaluation

Improving and Sustaining Change:

Improvement Plans

Theories of Change:Logic Model

Continuous Quality

Improvement

The mission of the

Comprehensive

Community Mental

Health Services for

Children and Their

Families Program is to

encourage the

development of

intensive community-

based services for

children with serious

emotional disturbance

and their families

based on a multi-

agency, multi-

disciplinary approach

involving both the

public and private

sectors.

Practice Outcomes

• Service providers integrate system of care principles and values into practice

• Children and families receive coordinated and useful services and supports in the community

Child and Family Outcomes

• Children's distressing symptoms are reduced

• Children have improved ability to function at home, in school, and in their community

• Improved family functioning and reduced caregiver strain

System Outcomes

• Families are full partners in policy and implementation

• Agency partnerships are broadened and deepened

• Comprehensive, coordinated, efficient, and accountable service array is developed

• Resources are appropriately allocated and utilized locally

• System of care is sustained with stable, long-term funding

• Child and family satisfaction with services is improved

Practice Context

• Practices have traditionally promoted the use of restrictive placements and services

• Service providers need to meet multiple needs of children and families that cross agency boundaries

• Need coordination among service providers

Child & Family Context

• Children under 22 years of age and their families

• Diagnosis of emotional, behavioral, or mental disorder

• Level of functioning in family, school, and/or community environments is limited

• Two or more community agencies involved

• Disability must be present at least one year

System Context

• Federal Center for Mental Health Services funds and supports systems of care with: Leadership, Technical assistance, Consultation, Evaluation

• Local matching funds and resources

• Need for comprehensive array of community-based, culturally competent and family-focused services

• Need for family advocacy

• Family-focused: Services and supports should consider the needs and strengths of the entire family.

• Individualized: Services and supports should be tailored to the needs and strengths of each child and family.

• Culturally competent: Services and supports should be sensitive and responsive to the cultural characteristics of children and their families.

• Least restrictive: Service planning should balance a child and family's need to interact in school and community settings with the most appropriate services and supports.

Core Values are

Family-driven

Culture-based• Community-based: Services and supports should be provided in the child and family's community.

• Accessible: Access to services and supports should not be limited by location, scheduling or cost.

• Interagency: Core agencies providing services and supports should include mental health, child welfare, juvenile justice and education.

• Coordination/collaboration: Partner agencies, providers and organizations should provide a seamless system of services and supports for children and families.

Individualized

& flexible services/supports

Family & child partners Community member partners

State & Federal

agency partners

Local agency

& organization

partnersCommunity

ownership and

planning

Logic Model Population Guiding Principles System of Care Strategy

Local Service Delivery Process:

System entry, service planning, service provision, and

review/monitoring of the care of individual children and families

Outcomes

Local Infrastructure Development:

Governance, management, quality monitoring and array of

services/supports

Comprehensive Community Mental Health Services for Children & Their Families

>> Adaptation >> >> Accountability >>

>>

Qu

alit

y Im

pro

vem

en

t >

>

<< Internal Evaluation << << Using Best/Current Research <<

Evalu

atio

n a

nd

feed

back to

sup

port im

pro

ved

serv

ice d

eliv

ery

Project Tapestry

The CQI Process and Using the CQI Progress Report

Evaluator and Project Director Collaboration: Our experience.…

Interpreting the measures and delving into the details Understanding the meaningfulness of the data at the local

level Being comfortable with saying “I have no idea what this

means” It says right here we are terrible! It says right here we are great! Staying strengths based Forming a CQI team/workgroup Prioritizing the indicators Talking about how to affect and monitor change Communicating the CQI data in the community Networking with other grant communities and drawing on

past experience National partners and supports

Communicating the Data to the Community: Seeing the Big

Picture

√++

Total site score and domain score

Identifying Priorities: Start Small… But Start Somewhere!

Identifying Priorities (Cont.)

Next Steps Continue to understand the measures better. Be an active consumer and developer of the CQI. Work closely with providers and “change agents” to

get buy in…people must believe these are meaningful indicators if they are going to act on them.

Start a “what can I do about this” dialogue. Prioritize the indicators and look at strategies for

change. Build specific plans for change around priority

indicators Connect with TA partners and look at available

supports to help us improve. Implement change strategies. Closely watch our performance in future CQI reports. Be ready to try new strategies.

Small Group Discussions

What CQI efforts are in your community? What are some CQI efforts that can be put in

place? How important is the evaluator, project director,

key stakeholder relationship? What do these relationships look like in your

community? Have you used the CQI Progress Report? If not,

why? What can be done to help you in your CQI efforts?

Contact Information

Angela SheehanPh. (646) 695-8122

Email: [email protected]

Beth DaguePh. (216) 479-3297

Email: [email protected]

Chris StormannPh. (330) 672-0394

Email: [email protected]

Teresa KingPh. (216) 363-1019

Email: [email protected]