PUSHING THE ENVELOPE THROUGH A QUALITY MANAGEMENT FRAMEWORK:CHALLENGING A TRADITIONALIST OUT OF ITS COMFORT ZONE.

PUSHING THE ENVELOPE THROUGH A QUALITY MANAGEMENT

FRAMEWORK:CHALLENGING A TRADITIONALIST OUT OF ITS

COMFORT ZONE

Aims of the paper

• To underscore the importance of organisations having a way of measuring and managing the quality of their services;

• To show how The Centre adapted the QMF to suit its own need;

• To overview The Centre’s QMF; and • To identify the challenges encountered during

this exercise.

About The Centre for Cerebral Palsy

• It provides a range of services to children and adults with cerebral palsy and their families.

• Has been in operation for approximately 60 years.

• Often called a ‘traditionalist’ organisation.

The QMF sets out to:• Outline the Commission’s expectations of its

funded agencies;

• Establish a better link between individual aspirations, goals and objectives of clients and available services;

• Shift the focus of assessment/evaluations from process to outcomes; and

• Increase accountability.

The main items of the framework

The Commission’s QMF: • reinforces the importance of:– clients living and participating in the community; – person-centred planning of services.

• incorporates 15 broad outcomes areas, 17 outcomes, and 64 performance indicators.

The framework

The Commission’s QMF:

• Is an important shift

• We support the shift

Old model versus the new

From:

• process/outputs → outcomes.

• the ‘how’ → the ‘why’ services are provided. • service focus → individuals and families.

Reasons for adapting the QMF:• A daunting document;

• Not a holistic document;

• Potential to encourage silo mentality between programs; and

• Largely a framework that was not owned by organisations.

What the Centre hoped to achieve by adapting framework

• Simplification

• Ownership by organisation and staff

The principles underpinning the changes

• Integrity of DSC’s framework;

• Staff involvement and ownership;

• Easier to implement; and

• Amoebic.

Two broad strategies for achieving intent of adapting QMF

• Compression; and

• Developing systems.

Outcome AreasTCCP OUTCOME AREAS DSC OUTCOME AREAS Community Inclusion and Participation Participation

Social participation Social connectedness Welcoming communities

Health and wellbeing Wellbeing Independence Independence

Personal Independence Lifelong learning Lifelong learning Relationships and Social

connectedness Relationships and social connections Enhanced natural supports Positive relationships support networks

Home and lifestyle Lifestyle Home Lifestyle of choice

Performance IndicatorsHOME AND LIFESTYLE PIs - DSC HOME AND LIFESTYLE PIs - TCCP

Individuals make informed choices Individuals and families are supported to have the lifestyle of their choosing

Individuals are safe from neglect and abuse Individuals are safe, secure and comfortable, and free from neglect and abuse

Individuals are supported to have the lifestyle that they choose

Individuals and families are satisfied with their chosen lifestyle and services are conducive to their lifestyle and culture

Individuals satisfaction with lifestyle choices Individuals identify where they live as their home Individuals have a sense of ownership and dominion Individuals have their own space Individuals are safe secure & comfortable Individuals are able to make informed choices and

be themselves Individuals satisfaction with their homes Individuals, families & carers are central in decision

making about their services and lifestyle Individuals, families & carers make informed choices Individuals, families & carers identify that services

provided fit their lifestyle and culture Individuals, families and carers are satisfied with

their chosen lifestyle

MeasuresTCCP’s Compressed PIs – home & lifestyle TCCP’s Qualitative and Quantitative Measures – 

home and lifestyle

Individuals and families are supported to have the lifestyle of their choosing

% of individuals with a plan identifying wishes, goals and choices

% of individuals living in homes that reflect their tastes, preferences and choice

The extent to which individuals/families are satisfied with:

- information provided;- choice and decision making; and- sense of ownership of living arrangements.

Individuals are safe, secure and comfortable, and free from neglect and abuse

% staff trained in protective behaviours % of complaints relating to neglect and abuse The extent to which the family is happy with:- information provided; and- the manner in which the complaint is handle.

Individuals and families are satisfied with their chosen lifestyle and services are conducive to their lifestyle and culture

The number of respite options available to individuals and families

% of families seeking specific respite options The extent to which individuals/families are

satisfied with:- choice and decision making in home routines; and- services reflecting their culture.

Difficulties in implementing an outcomes based framework

• Difficult to understand;

• Require different service mindset;

• Benefits not obvious;

• Confusion about measurement;

• Needs involvement of all staff;

• Easier to focus on lower level indicators;

• Need systems and processes; and

• Transparency and accountability challenging.

Systems and processes• Necessary systems and processes not in place.

• Need person centred plans, individualised plans.

Progress relating to person-centred planning

• Developing personalised plans in therapy services and accommodation.

• 30 will be completed by year’s end. • Training.

• Personalised plans → information → outcome based framework.

Further boosts for QMF’s implementation

• Future contracts

• Role of independent evaluators & evaluations– It is also likely that organisations will be

encouraged to develop process and system for implementing the framework once a program area is evaluated under the new model.

• Good for individuals and families

Conclusion

• The quality management framework pivotal in bringing about positive achievements for clients

• Currently is too complex• Significant change • Path to implementation hazardous in the

short to medium term• But shift to outcome focus must occur