1. The Qualitative Service Review Process Overview
Developed by
The Child Welfare Policy and Practice Group
& its QSR Institute Division

2. The QSR is a Practice Improvement Approach Designed to Assess Current Outcomes and System Performance by Gathering Information Directly From Families, Children and Service team Members
What is the QSR?
The Child Welfare Policy and Practice Group/QSR Institute

3. Reviewer Skills and Abilities
Understand how the overall QSR process works
Understand the basics of the protocol content
Understand the application of interview techniques relative to the protocol
Develop the ability to score status and performance
Learn how to provide worker feedback
Understand the case debriefing process
Learn the structure of a written case story
Reviewer Skills and Abilities
The Child Welfare Policy and Practice Group

4. Reviewer Skills and Abilities
Basic understanding of the QSR Process
Ability to employ active
Ability to accurately summarize the QSR process to respondents
listening
Ability to employ basic interviewing skills
Knowledge of the protocol
Ability to anticipate directions in the course of interviews
Understanding of scoring rules
Ability to distinguish effort from performance
Ability to engage respondents
Reviewer Skills and Abilities
The Child Welfare Policy and Practice Group

5. Reviewer Skills and Abilities
Ability to use confidentiality appropriately
Ability to observe the boundaries of the reviewer role
Ability to score objectively
Ability to accurately summarize the case in debriefings
Ability to provide accurate, strength-based worker feedback
Ability to write a descriptive and accurate case story that supports the scores assigned
Reviewer Skills and Abilities
The Child Welfare Policy and Practice Group

6. Developed during Alabama’s class action child welfare lawsuit
Unique settlement focused on practice, not process
Answered the question – How do you judge compliance with practice principles?
Met organizational needs (feedback on performance) as well as settlement needs
How was it created?
The Child Welfare Policy and Practice Group

7. Where has the QSR process been used?
Alabama
Tennessee
New Mexico
Oregon
North Carolina
Hawaii
New Jersey
Florida
Iowa
NYC
Washington DC
Georgia
Indiana
Missouri
Utah
Kentucky
Wisconsin
Pennsylvania
Los Angeles
Virginia
Where has the QSR process been used?
The Child Welfare Policy and Practice Group

8. QSR Settings Child Welfare Mental Health Special Education
Juvenile Justice
Welfare to Work
QSR Settings
The Child Welfare Policy and Practice Group

9. How is the QSR different from case file reviews?
If you didn’t document it didn’t happen.
The worker and family’s team can verify agency practice in interviews.
Did you do it on time?
Timely or not, did the casework achieve the right outcome?
Were services provided?
Did you meet the child and family’s needs?
Is there a case plan on file?
Does the family see the plan as their own?
How many moves has the child experienced?
Does the team understand why the child is unstable?
How is the QSR different from case file reviews?
The Child Welfare Policy and Practice Group

10. Shifting from Blaming to Safe Learning*
Blame the Person
Improve the System
Individual: Let’s find-out who messed up, “ding‘em,” require “Corrective Action!”
Person Focus: Who did it? What you did was wrong!
Punishment: It’s your fault! [Got Ya!]
Cover-up/Fear =
No Learning: I won’t reveal my mistakes. It’s not worth it to take risks.
*Human Systems & Outcomes Inc
System: Let’s find things in our system that increase problems and reduce good results
Problem Focus: What happened here?
Performance: Let’s see what we can do to get the results we want!
Openness & Safe Learning: We want to learn more about this problem so that we can do better in the near future!

11. How is information gathered?
Through a small representative sample of randomly chosen cases
Using a structured protocol
Through interviews with all members of a case team
A professional appraisal of case status and performance
Identifying what’s working and not working and why
Yielding an aggregate status and performance score, immediate feedback to caseworker and site, written case story and ideas for case and systemic analysis
How is information gathered?
The Child Welfare Policy and Practice Group

12. Child and Family Status
Safety from Exposure to Threats of Harm
Child Vulnerability
Stability
Living Arrangement
Permanency
Overall Physical Health
Emotional Well-Being
Early Learning & Development (0-5 years)
Academic Status (6-18+years)
Pathway to Independence
Parent & Caregiver Functioning & Resourcefulness
What gets assessed?
The Child Welfare Policy and Practice Group

13. What gets assessed? Practice Performance Engagement Efforts
Voice & Choice
Teamwork
Assessment & Understanding
Planning for Safe Case Closure
Supporting Transitions & Life Adjustments
Implementation
Maintaining Quality Connections
Evaluating and Adjusting
Psychotropic Medication Management
What gets assessed?
The Child Welfare Policy and Practice Group

14. Who is interviewed? Case manager
Parents and child (interviewed or observed)
Kin (in some cases)
Foster parents
Therapists
Teacher
Other providers and professionals
Attorneys
Whoever is important in the case
Who is interviewed?
The Child Welfare Policy and Practice Group

15. How the Review Process Works
Random representative sample of cases
Structured protocol guides inquiry and scoring
Family permission obtained to participate in review and information releases obtained
Key informants in each case identified and appointments scheduled
Lead reviewers and partners conduct the interviews, beginning with the caseworker
Case is scored and review results aggregated
How the Review Process Works
The Child Welfare Policy and Practice Group

16. How the Review Process Works
Feedback session with caseworker and supervisor to provide immediate feedback and elicit further suggestions for next steps on case
Presentation of stories at debriefing sessions during the week
Case story for each case reviewed
Final report which includes aggregate data, case stories and systemic analysis
How the Review Process Works
The Child Welfare Policy and Practice Group

17. Understanding the QSR Indicators
What’s being measured? Difference from current description? What do we need to learn to score this indicator? Examples of circumstances not meriting an acceptable rating?
Child and Family Status
Safety from Exposure to Threats of Harm (Home & School)
Child Vulnerability
Stability
Living Arrangement
Permanency
Overall Physical Health
Emotional Well-Being
Early Learning & Development (0-5 yrs)
Academic Status (6-18 yrs)
Pathway to Independence (14+yrs)
Parent & Caregiver Functioning & Resourcefulness
Understanding the QSR Indicators
The Child Welfare Policy and Practice Group

18. Understanding the QSR Indicators
What’s being measured? Difference from current description? What do we need to learn to score this indicator? Examples of circumstances not meriting an acceptable rating?
Practice Performance
Engagement Efforts
Voice & Choice
Teamwork (Formation & Functioning)
Assessment & Understanding (Child and Family)
Planning for Safe Case Closure
Supporting Transitions & Life Adjustment
Implementation
Intervention Adequacy and
Resource Availability
Maintaining Quality Connections
Evaluating and Adjusting
Understanding the QSR Indicators
The Child Welfare Policy and Practice Group