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

2 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 3 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

4 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 facility 1. Collecting client data 2. Analyzing client data and producing reports 3. Constructing personal care plans 4. Collecting additional data 5. Constructing a yearly work plan 6. Internal quality assurance processes Year without Comprehensive Inspection Process Regular inspector visits 4. Collecting additional data 7. Decisions about licensing the facility 1. Collecting client data 2. Analyzing client data and producing reports 3. Constructing personal care plans 6. Internal quality assurance processes 5. Comprehensive inspection process Year of Comprehensive Inspection Process Index: Inspection processes Processes at the facility Initial follow-up Regular inspector visits Feedback to the facility & constructing a yearly work plan Comprehensive visit

6 Types 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

7 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

8 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

9 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

10 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 way 9.Immediate response to obstacles

11 Thank You

12 The Ministry of Social Affairs The RAF System The Children and Youth Services AgeGenderFirst Name Family Name I.D. 10 M M 9 M F 9 F 7 M M 11 M 13 M 10 F 11 F 10 F 13. Suicidal behavior 11. Drug abuse9. Enuresis7. Problematic social behavior 5. Problematic relations with family 3. Running away 1. Low achievement at school List of Tracers 14. Problematic sexual behavior 12. Depression and anxiety 10. Alcohol use8. Theft6. Aggression4. Physical self-neglect 2. Behavior at school 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 Report