1. 1 Strengthening Child Welfare Supervision as a Key Practice Change Strategy Unit 2: Preparing to Redesign Child Welfare Supervision

2. 2 Results from Unit 1: Helping Child Welfare Leaders Re-conceptualize Supervision

3. 3 Supervisors as Practice Change Agents Provide clinical supervision –Proactively direct the achievement of the outcomes established by agency leaders Lead change –Define what future practice should look like –Align staff with that vision –Inspire them to make it happen

4. 4 Supervisors as Practice Change Agents Why supervisors? –Critical link between administrators and frontline workers –Highly visible role models for workers –Give clinical direction that guides what workers do with children and families

5. 5 A New Role for Supervisors: Practice Change Agent Agency Leaders and Stakeholders Define the mission, vision, values, and desired outcomes for the agency Supervisors Lead the change in practice to achieve those outcomes Frontline Workers Implement practice changes in a team with supervisor and coworkers

6. 6 New Vision for Supervision The value and importance of supervisors to the agency’s mission Leadership’s vision of the supervisor’s role and responsibilities in achieving the agency’s mission New practice change agent roles that will be added or revised –Use of Data –Clinical Supervision Current roles that will be will be revised Current roles that will be removed

7. 7 Charge for Planning Structure Role –Develop a strategic plan to redesign supervision in accordance with the vision just described Use of Data Clinical Supervision Duration Plan to Communicate with Leaders –Method –Frequency Supports from Leaders

8. 8 Supervisors as Practice Change Agents: Use of Data Supervisor Involvement in the Child and Family Services Reviews and Program Improvement Plan

9. 9 Overview CFSR –Federal and State partnership for improving outcomes for children and families –First phase: Statewide Assessment –Second phase: Onsite Review - Conformity with requirements is determined –Third Phase: PIP - Plan to address identified areas needing improvement

10. 10 Taking an Active Role 1.Participate in CFSR Statewide Assessment 2.Participate in CFSR Onsite Review 3.Participate in PIP Development

11. 11 1. Participate in CFSR Statewide Assessment Assess agency performance –7 outcome areas –7 systemic factors Present changes in practice and performance that resulted from PIP Assess agency’s strengths and challenges Identify issues and geographic locations for further examination during onsite review

12. 12 2. Participate in CFSR Onsite Review Gather information –case file reviews –case-related interviews with children, parents, foster parents, caseworkers, and other professionals involved with the child Answer key questions about each case Provide ratings to indicate strengths, areas needing improvement, and levels of outcome achievement

13. 13 3. Participate in PIP Development Help interpret the CFSR results by region or by office Identify practice or systems issues that contribute to the problems Provide input into the creation of strategies and action plans Help top management “reality-test” reasons for the results and viable strategies for improvement

14. 14 1. Participate in CFSR Statewide Assessment Statewide Assessment Instrument –Section I General information about agency –Section II Data profiles for safety and permanency outcomes Prepared by Administration for Children and Families (ACF) based on AFCARS and NCANDS data Provided to Statewide Assessment Team by ACF

15. 15 1. Participate in CFSR Statewide Assessment Statewide Assessment Instrument –Section III Narrative assessment of state performance in 7 outcome areas –Section IV Narrative assessment of state performance on 7 systemic factors –Section V Assessment of state strengths and challenges Issues and geographic locations for further examination during onsite review

16. 16 1. Participate in CFSR Statewide Assessment Statewide Assessment Instrument: Activity –Review portion of previous statewide assessment –Consider how answers might be different in next round –If more information is necessary, determine What needs to be gathered Where it can be located Who can provide it

17. 17 2. Participate in CFSR Onsite Review Onsite Review Instrument –Face Sheet General information about the agency, reviewer, and case –Section I: Safety (4 items) –Section II: Permanency (12 items) –Section III: Well-Being (7 items) All sections include a) questions and ratings for each item and b) ratings for overall level of outcome achievement –Case Rating Summary

18. 18 2. Participate in CFSR Onsite Review Onsite Review Instrument: Activity –Complete the CFSR excerpt using the case provided

19. 19 3. Participate in PIP Development Review CFSR Results –Refer to handout for summary of your state’s CFSR results

20. 20 3. Participate in PIP Development Interpret CFSR Results: Activity –Review data –Interpret results Identify differences across locations Discuss possible reasons for differences

21. 21 3. Participate in PIP Development Develop the PIP 1.General information with key contact information 2.A written work plan detailing the work to be undertaken a measurable goal of improvement, action steps, and timeframe for addressing each outcome and systemic factor that has been found not to be in substantial conformity a specific percentage of improvement (goal) that will be achieved through the PIP for each statewide aggregate data indicator that does not meet the national standards

22. 22 3. Participate in PIP Development Develop the PIP 2.A written work plan detailing the work to be undertaken individual(s) responsible for undertaking each action step geographic areas of the state in which the action steps will be undertaken a plan for evaluating the implementation of the provisions of the PIP, including benchmarks of progress a plan for accessing technical assistance resources a description of how PIP progress will be evaluated by the state and reported to ACF

23. 23 3. Participate in PIP Development Develop the PIP 3.An agreement form indicating approval of the PIP by the ACF Regional Office and the State 4.A tracking matrix summarizes the components of the PIP initially permits tracking of progress and completion dates through quarterly status reports

24. 24 3. Participate in PIP Development Develop the PIP: Activity –Refer to Section II: Strategies for Developing the PIP –How were supervisors involved in the PIP after the last CFSR? –How might supervisors be more involved in the next PIP?

25. 25 Supervisors as Practice Change Agents: Use of Data Supervisor Involvement in Quality Assurance or Continuous Quality Improvement

26. 26 Overview Quality Assurance in the Past –Traditionally focused on compliance with state and federal requirements –Paralleled federal approaches to monitoring

27. 27 Overview Quality Assurance Today –Assess practice and outcomes, in addition to compliance –Attempt to use data, information, and results to effect positive changes in policy and practice –Engage a broad range of internal and external partners in the process (e.g., top managers, staff at all levels, children and families served, and other stakeholders) –Often referred to as Continuous Quality Improvement (CQI)

28. 28 Taking an Active Role 1.Serve as a reviewer 2.Interpret results of reviews 3.Review cases during supervision 4.Receive performance feedback Prepare, access, or receive reports Communicate with QA/CQI staff

29. 29 1. Serve as a Reviewer Activity –Review and rate the case provided using the assigned section of your state’s review tool –How was the experience of reviewing a case? –Do you have any particular reactions or new insights? –How might serving as a reviewer influence how you supervise? –Is this a practice change strategy the group would consider recommending to the agency?

30. Adapted from "Results Oriented Management" 2002 U. of Kansas 30 2. Interpret Results of Reviews Steps in the Analytic Process –Initial Identification—how are we performing? –Postulating and Hypothesizing—what might explain this performance? –Testing and Findings—of these factors, what can be verified? –Drawing Conclusions—what can we conclude from these data?

31. Adapted from "Results Oriented Management" 2002 U. of Kansas 31 2. Interpret Results of Reviews Step 1: Initial identification—how are we performing? –What is the unit or agency’s level of performance? –Is the performance meeting an established standard? –How does the performance compare to other management units? –Has performance changed over time?

32. Adapted from "Results Oriented Management" 2002 U. of Kansas 32 2. Interpret Results of Reviews TRUE OR FALSE? 1.The outcome "Reunification in less than 12 months” is consistently being met. 2.The outcome "Reunification in less than 12 months" has improved in the last six months. 3.The outcome "Reunification in less than 12 months" shows improvement, but the number of reunifications has fallen off over the year. 4.Performance on the outcome "Reunification in less than 12 months" is so good that there should be an agency- wide celebration.

33. Adapted from "Results Oriented Management" 2002 U. of Kansas 33 2. Interpret Results of Reviews TRUE OR FALSE? 5.The outcome "Reunification in less than 12 months" is being achieved by all areas but Area V. 6.The outcome "Reunification in less than 12 months" is so high in Area II that someone ought to find out what Area II is doing so well. 7.The outcome "Reunification in less than 12 months” is good in Area 1, but one would wonder why this area has reunified so few children compared with other areas.

34. Adapted from "Results Oriented Management" 2002 U. of Kansas 34 2. Interpret Results of Reviews Step 2: Postulating and hypothesizing –What factors might explain this performance? Client factors Services factors Organizational factors Community factors

35. Adapted from "Results Oriented Management" 2002 U. of Kansas 35 2. Interpret Results of Reviews Step 3: Testing and findings—what can be verified? –Three main information sources Reports systems and data bases Collective brain trust Case records (files) –Verifying relationships requires comparisons between groups on outcomes Only compare mutually exclusive subpopulations

36. Adapted from "Results Oriented Management" 2002 U. of Kansas 36

37. Adapted from "Results Oriented Management" 2002 U. of Kansas 37 Is it fair to conclude that the unit is doing a better job of reuniting white children than children with disabilities?

38. Adapted from "Results Oriented Management" 2002 U. of Kansas 38 Developing Hypotheses

39. Adapted from "Results Oriented Management" 2002 U. of Kansas 39 2. Interpret Results of Reviews Step 3: Testing and findings—what can be verified? –Hypothesis Example 1 Do children whose visitation requirements were met achieve reunification in less than 12 months more often than those children for whom visitation requirements were not met? Focuses on the Services Factor (visitation)

40. Adapted from "Results Oriented Management" 2002 U. of Kansas 40 2. Interpret Results of Reviews Step 3: Testing and findings—what can be verified? –Hypothesis Example 2 Do children who are neglected get reunified in less than 12 months more often than those children referred for other types of abuse? Focuses on the Client Factor (referral type)

41. Adapted from "Results Oriented Management" 2002 U. of Kansas 41 2. Interpret Results of Reviews Step 3: Testing and findings—what can be verified? –What is it about Factor X that is influencing performance? –Analyze data to isolate and confirm that certain factors appear to affect an outcome –But, it might be something else….. –Be sure to consider alternative explanations, but know when to stop

42. Adapted from "Results Oriented Management" 2002 U. of Kansas 42 2. Interpret Results of Reviews Step 4: Drawing conclusions –Develop the most plausible explanation and draw your conclusion about how best to take action –Avoid making statements about causation on the basis of just observing a correlation (association)

43. Adapted from "Results Oriented Management" 2002 U. of Kansas 43 2. Interpret Results of Reviews Activity –Sue’s Case Scenario –Identify performance problem –Practice 4 steps of analytic process –Learn how the problem was resolved

44. 44 3. Review Cases During Supervision Supervisory Case Review Tool –Based on CFSR –Used to help workers improve practice by learning the connections between case practice and outcomes –Used to review 1 case per worker per quarter

45. 45 3. Review Cases During Supervision Supervisory Case Review Tool –Questions to consider What is your initial reaction to this type of tool? What are the anticipated advantages or disadvantages of supervisor use of this type of tool? How might using a tool like this influence how you supervise? Is this a practice change strategy the group would consider recommending to the agency?

46. 46 4. Receive Performance Feedback Copyright © 2003 University of Kansas School of Social Welfare. All rights reserved. Used with permission.

47. 47 4. Receive Performance Feedback Relevant –Aggregated for your management unit –Timely Easy –Easy to read –Provide trends –Measure percentages –Provide comparisons

48. 48 4. Receive Performance Feedback Stresses Outcomes –Emphasize outcomes through report design –Show progress toward outcome achievement Utility –Identify cases –Drill down for analysis

49. 49 4. Receive Performance Feedback Lean –Fewer Reports –Data Summarized Trustworthy –Accurate –Verifiable Standards –Draw standard lines on graphs –Show the extent over or under

50. 50 4. Receive Performance Feedback Activity –Complete survey to evaluate the quality of existing management reports –Share responses –Discuss What types of changes will need to be made to the management report system? What existing reports are helpful? What existing reports should be modified? What types of reports do not currently exist that would be helpful?

51. 51 Supervisors as Practice Change Agents: Clinical Supervision

52. 52 Clinical Supervision Expectations and Practice Establishing expectations Expectations in another state Clinical case review example How might clinical supervision look in your agency?

53. 53 Using Data and Supervision to Change Practice

54. 54 Using Data and Supervision to Change Practice Knowledge of Data + Clinical Supervision = Practice Change Action Menu –Individual cases (clinical supervision) –Agency systems –Key collaborations –Staff capacity –Resources –Rewards

55. 55 Activity 1 CFSR Outcomes and Items CFSR Questions SACWIS Field or Report Supervisor Actions or Directions

56. 56 Activity 1 Select an outcome and item from handout Read associated CFSR questions Identify relevant SACWIS fields or reports Generate possible supervisory actions or directions that can improve outcomes Rotate worksheets across groups and add to columns 3 and 4 Share most promising or innovative ideas

57. 57 Activity 2 Read assigned scenarios Answer associated questions Report answers to large group

58. 58 Motivating Staff to Change Practice

59. 59 A New Role for Supervisors: Practice Change Agent Agency Leaders and Stakeholders Define the mission, vision, values, and desired outcomes for the agency Supervisors Lead the change in practice to achieve those outcomes Frontline Workers Implement practice changes in a team with supervisor and coworkers

60. 60 Resistance Feelings of loss of control Fear of failure Uncertainty about the future Negative experiences with past changes Possible need for more effort and work Little or no warning of impending change

61. 61 Building Commitment Build a shared sense of the future by communicating the vision and strategies –Keep message simple –Convey a sense of urgency –Use multiple means of communication –Repeat the message –Listen, answer questions, and solicit feedback –Explain apparent inconsistencies

62. 62 Building Commitment Serve as a role model and lead by example Involve workers and reinforce their role in achieving outcomes Remove barriers and provide supports Recognize and reward successful change, without undermining momentum

63. 63 Activity Think about a time you implemented (or tried to implement) a practice change that required acceptance and commitment from staff Briefly share your experiences with one another and select one past experience for the group to focus on for the purpose of the exercise Evaluate the practice change by answering the handout questions

64. 64 The Strategic Planning Process

65. 65 Four Primary Steps 1.Preparation 2.Development 3.Implementation 4.Revision

66. 66 1. Preparation Vision: the ideal future image of supervision Mission: the purpose of supervision in the agency Guiding principles, values, and beliefs: the standards and ideals that guide supervision

67. 67 2. Development 1.Assess current reality of the agency 2.Prioritize needs, strengths, and resources 3.Address five key questions –What do we want to accomplish? –What we will do to get there? –How will we know if we are making progress? –Who will be responsible? –What is the time frame for completion?

68. 68 3. Implementation Strategic plan is communicated and implemented Progress is monitored and reported

69. 69 4. Revision Progress is reviewed and the plan is revised as needed All steps are reassessed, and updates are made when necessary

70. 70 Next Steps and Work Plan Strategic planning step Tasks to be accomplished Meeting date and time –It is recommended that the group plan to follow up with agency leaders after every meeting to inform them of progress and recommendations