Performance and Quality Improvement COA Standards Understood Updated 2018

Purpose An organization-wide Performance and Quality Improvement system advances: efficient and effective evidence-informed service delivery effective management practices the achievement of strategic and program goals.

Discussion: How does Parkside determine whether or not service delivery is efficient? Effective? How do management practices impact service delivery? How does Parkside assure staff know a program’s goals? How are strategic goals linked to program goals?

COA Standards COA’s Performance and Quality Improvement (PQI) standards encourage organizations to use data to identify areas of needed improvement and implement improvement plans in support of achieving: performance targets program goals client satisfaction positive client outcomes.

Discussion: Are “performance targets” always the same as “client outcomes”? Are program goals shared with all participants? Why is client satisfaction important? Should staff satisfaction play a part in performance and quality improvement?

Involvement COA’s comprehensive approach to PQI is the promotion of a broad-based, organization-wide process inclusive of staff and stakeholders, as a vital, necessary management tool. Taken together, the standards include practices that counter the tendency of organizations to place responsibility for quality improvement and results in one or a few individuals. As such, the standards recognize the value of involving staff at all levels of the organization.

Discussion The Parkside PQI Committee includes clinical and non-clinical staff, management, an advisory board member, students, and consultants. How else might Parkside promote “organizational wide” participation in Performance an Quality Improvement?

Culture of Improvement The organization’s leadership demonstrates a clear commitment to fostering a culture of excellence and continual improvement by:  using quality improvement results to build capacity and improve practice;  allocating resources for an organization-wide PQI system; making data-informed decisions.

Discussion Who is the “organization’s leadership”? How does one set forth quality expectations? What “resources” should be allocated to PQI? Is using “data-informed decisions” the same as using “evidence based” treatment modalities? How are strategic goal setting and PQI related?

Infrastructure A PQI system has an infrastructure that has the capacity to: identify organization-wide and program-specific issues; implement solutions that improve overall efficiency; and deliver accessible, effective services in all regions and sites.

Discussion Does Parkside’s PQI Program take into account all programs? Parkside’s current PQI plan was written in 2018, have you read it? How do you define Parkside’s stakeholders? Should an improvement cycle include analysis as to whether or not a change is an improvement? What skills or education might qualify staff to analyze results and communicate outcomes?

Roles and Responsibilities Staff throughout the organization participate in, conduct, and sustain performance and quality improvement activities. Many improvement activities involve change. At Parkside, we use the Lewin Model of Change Management.

PQI Infrastructure

Discussion Is data collection and inputting worthwhile uses of our time? Are social workers and counselors sufficiently versed in data collection, analysis, and reporting? How can we improve in these areas? What support mechanisms would be beneficial to improved data collection?

Performance and Outcomes Measures The PQI system identifies measures to build organizational capacity, improve services, and meet contracting and reporting requirements, by evaluating:  Outputs (quantifiable data)  Outcomes (changes in status) Quality (service delivery integrity) Administrative Performance (process review)

Discussion What is the difference between qualitative and quantitative indicators? What sort of measurement tools does Parkside currently use? What are some of Parkside’s preferred client outcomes? How important is consumer satisfaction? How would you measure management or operational performance? With whom should Parkside share outcomes?

Improvement Plans Are Needed When: When the data indicates a concern When there are inefficiencies in service delivery To correct underperformance To meet the expectations placed on staff To further develop successful programs To increase involvement

Improvement = Change Parkside utilizes a prescribed model of change, The Lewin Change Model, so that Everyone will know what to expect during times of change Communication is prioritized Proper planning occurs Someone is “in charge” The change is evaluated for efficacy

The Lewin Model of Change

Case Record Review The organization conducts client case record reviews on an ongoing basis for each of its services to: minimize the risks associated with poorly maintained case records; document the quality of the services being delivered; and identify barriers and opportunities for improving services.

Discussion Explain how case record maintenance might be a risk management issue. Who should review case records? Is a case record a reliable source of data? How should the need for continued services be indicated in a case record? If a record is incomplete, what should be done about it?

Analyzing and Reporting Information The organization systematically collects, aggregates, analyzes, and maintains data for each service area: Mental Health (Outpatient) Substance Use Disorder Services Intensive Home-based Treatment School-based Services Administration and Operations Education and Support Groups

Discussion Does reviewing and aggregating data ensure data integrity? Can data tracking demonstrate improved performance? How? What are “benchmarks”? What is a trend analysis? What would be the best way to distribute findings?

Sharing Findings Different Programs collect different data on different timetables. How then can data be shared effectively? Monthly Parkside Pride Quarterly PQI Updates Quarterly Reports to the Advisory Board Staff Meetings End of School Year Reports End of Calendar Reports PQI Annual Report

Encouraging Greatness Parkside Family Counseling acts on findings to build capacity, improve programs, and have a positive impact on persons served. When we positively impact service to our community it provides us a reason to celebrate, reward, and above all, recognize achievements.

Discussion How should we develop solutions to performance issues? How do we encourage the replication of good practice? How can we integrate Performance and Quality Improvement goals with staff recognition and rewards? Who is ultimately responsible for PQI?