1. Fostering Local and National Collaboration to Support Continuous Quality Improvement Angela Sheehan, ORC Macro Beth Dague, Project Director, Project Tapestry Chris Stormann, Evaluator, Project Tapestry Teresa King, Family Lead, Project Tapestry

2. Local and National Collaboration  What is Continuous Quality Improvement (CQI)?  CQI Key Principles “It is because of these data that we can say systems of care work’” – Gary Blau, May 2006

3. Systems of Care CQI Framework Monitoring Progress: Evaluation Improving and Sustaining Change: Improvement Plans Theories of Change: Logic Model Continuous Quality Improvement

4. The mission of the Comprehensive Community Mental Health Services for Children and Their Families Program is to encourage the development of intensive community-based services for children with serious emotional disturbance and their families based on a multi-agency, multi-disciplinary approach involving both the public and private sectors. Practice Outcomes Service providers integrate system of care principles and values into practice Children and families receive coordinated and useful services and supports in the community Child and Family Outcomes Children's distressing symptoms are reduced Children have improved ability to function at home, in school, and in their community Improved family functioning and reduced caregiver strain System Outcomes Families are full partners in policy and implementation Agency partnerships are broadened and deepened Comprehensive, coordinated, efficient, and accountable service array is developed Resources are appropriately allocated and utilized locally System of care is sustained with stable, long-term funding Child and family satisfaction with services is improved Practice Context Practices have traditionally promoted the use of restrictive placements and services Service providers need to meet multiple needs of children and families that cross agency boundaries Need coordination among service providers Child & Family Context Children under 22 years of age and their families Diagnosis of emotional, behavioral, or mental disorder Level of functioning in family, school, and/or community environments is limited Two or more community agencies involved Disability must be present at least one year System Context Federal Center for Mental Health Services funds and supports systems of care with: Leadership, Technical assistance, Consultation, Evaluation Local matching funds and resources Need for comprehensive array of community-based, culturally competent and family-focused services Need for family advocacy Family-focused: Services and supports should consider the needs and strengths of the entire family. Individualized: Services and supports should be tailored to the needs and strengths of each child and family. Culturally competent: Services and supports should be sensitive and responsive to the cultural characteristics of children and their families. Least restrictive: Service planning should balance a child and family's need to interact in school and community settings with the most appropriate services and supports. Core Values are Family-driven Culture-based Community-based: Services and supports should be provided in the child and family's community. Accessible: Access to services and supports should not be limited by location, scheduling or cost. Interagency: Core agencies providing services and supports should include mental health, child welfare, juvenile justice and education. Coordination/collaboration: Partner agencies, providers and organizations should provide a seamless system of services and supports for children and families. Individualized & flexible services/supports Family & child partners Community member partners State & Federal agency partners Local agency & organization partners Community ownership and planning Logic Model Population Guiding Principles System of Care Strategy Local Service Delivery Process: System entry, service planning, service provision, and review/monitoring of the care of individual children and families Outcomes Local Infrastructure Development: Governance, management, quality monitoring and array of services/supports Comprehensive Community Mental Health Services for Children & Their Families >> Adaptation >> >> Accountability >> >> Quality Improvement >> << Internal Evaluation << << Using Best/Current Research << Evaluation and feedback to support improved service delivery

6. Project Tapestry The CQI Process and Using the CQI Progress Report

7. Evaluator and Project Director Collaboration: Our experience.…  Interpreting the measures and delving into the details  Understanding the meaningfulness of the data at the local level  Being comfortable with saying “I have no idea what this means”  It says right here we are terrible!  It says right here we are great!  Staying strengths based  Forming a CQI team/workgroup  Prioritizing the indicators  Talking about how to affect and monitor change  Communicating the CQI data in the community  Networking with other grant communities and drawing on past experience  National partners and supports

8. Communicating the Data to the Community: Seeing the Big Picture √++ Total site score and domain score

9. Identifying Priorities: Start Small… But Start Somewhere!

10. Identifying Priorities (Cont.)

11. Next Steps  Continue to understand the measures better.  Be an active consumer and developer of the CQI.  Work closely with providers and “change agents” to get buy in…people must believe these are meaningful indicators if they are going to act on them.  Start a “what can I do about this” dialogue.  Prioritize the indicators and look at strategies for change.  Build specific plans for change around priority indicators  Connect with TA partners and look at available supports to help us improve.  Implement change strategies.  Closely watch our performance in future CQI reports.  Be ready to try new strategies.

12. Small Group Discussions  What CQI efforts are in your community?  What are some CQI efforts that can be put in place?  How important is the evaluator, project director, key stakeholder relationship?  What do these relationships look like in your community?  Have you used the CQI Progress Report? If not, why?  What can be done to help you in your CQI efforts?

13. Contact Information Angela Sheehan Ph. (646) 695-8122 Email: Angela.K.Sheehan@orcmacro.com Beth Dague Ph. (216) 479-3297 Email: Dague@cccmhb.org Chris Stormann Ph. (330) 672-0394 Email: cstorman@kent.edu Teresa King Ph. (216) 363-1019 Email: king@cccmhb.org