11 Mayview Regional Service Area Plan (MRSAP) Tracking: Supporting Individuals in the Community June 18, 2008

22 MRSAP Tracking: Supporting Individuals in the Community Importance of Data MRSAP tracking process: What happens after a person is discharged? – Collect Data – Produce Reports – Distribute and Analyze Reports – Use the Information Early Warning Indicators and Critical Incidents

3 Data: The MOST Important Tool Develop a process to make sure people are receiving what they need AFTER discharge Data is INFORMATION… numbers, words, or stories Data helps us: – Understand what’s going on – Make decisions – Figure out needs – Advocate for change – Gain support for a project Data helps us to know about people

4 Why Track MRSAP Information? Oversight and Quality Improvement – Immediate, individual monitoring and response: making sure people are safe, receiving services/supports needed – Big picture monitoring for trends and outcomes: making sure process is working overall, progress toward goals The same data can be used for both types of oversight – the difference is how it’s reported

5 Process For Tracking After Discharge Starts with a Final CSP and Discharge into the Community

6 Collect Data Upon discharge, baseline information is entered into a secure database. Every month, counties report on each person discharged, including benefits, housing, services, and social supports Includes over 20 categories AlleghenyBeaverGreeneLawrenceWashington 250 Pieces of Information For each person discharged Collected every month Secure Database

7 Produce Reports 13 “production” reports are generated with daily, weekly, and monthly views of the data Some “production” Reports include – Detailed tracking of each individual – Contacts by provider – Residential updates – Overall summary reports Also can generate “ad hoc” reports Secure Database

8 Distribute & Analyze Reports are produced daily, weekly, and monthly, as well as “as needed” Reports are distributed to DPW, Steering Committee, Counties, and others as needed Data is analyzed at the individual and summary level

9 Use the Information Provide on-going monitoring Improve existing treatment and services Develop new services Strengthen interventions Improve access Identify Barriers Produce Reports Distribute & Analyze: Talk about it, What does it mean? Use the information: Monitor and Refine System Collect Data What we do with the information

10 Early Warnings Indicators and Critical Incidents Early Warning Indicators Alert county and treatment team that an event occurred that may be an indicator of a larger issue 11 potential indicators, for example, – For example: Elopement attempts, ER visits, police involvement, significant deviation from person’s routine activities and behaviors, refusal to take meds may pose a significant risk Critical Incidents Any serious incident involving an individual that occurs in the community 17 categories of incidents, for example, – arrests, injuries, hospitalizations, fire, housing changes, medication errors, missing persons, suicides, deaths

11 Providers must immediately report events to counties Counties must immediately report to DPW Supported by a web-based regional tracking system Real time, appropriate follow-up is monitored DPW will conduct an investigation called a root cause analysis (RCA) for very serious incidents Frequency and type of events are also monitored Early Warnings Indicators and Critical Incidents

12 Other Forms of Oversight Quality Improvement and Outcomes Committee: Focused on reviewing data, asking questions, making recommendations for quality improvement Community Care and Value Behavioral Health: Staff assigned to work with counties to coordinate services and monitor providers University of Pittsburgh Evaluation: Interviews with a sample of people discharged to report on outcomes in the community Consumer and Family Satisfaction Teams (CFSTs): Interview all people discharged every six months Clinical Assessment Team (CAT): In collaboration with the counties, provides medical assessments to people discharged Quality Management and Clinical Consultation (QMCC) Team: Works with counties and providers to monitor the quality and effectiveness of services, the effective coordination of services, and development of staff expertise to meet the complex and changing clinical needs of consumers.

13 MRSAP Tracking Assisting individuals in their recovery through ongoing and comprehensive monitoring of community services and supports.