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Kate Whitaker, Tracie Lansing HFA Peer Reviewer & TA/QA Training June 18 - 20, 2012 Fort Wayne, IN.

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Presentation on theme: "Kate Whitaker, Tracie Lansing HFA Peer Reviewer & TA/QA Training June 18 - 20, 2012 Fort Wayne, IN."— Presentation transcript:

1 Kate Whitaker, Tracie Lansing HFA Peer Reviewer & TA/QA Training June , 2012 Fort Wayne, IN

2 What To Expect Out of the Training Grounded in a CQI philosophy Understand the Site Visit Process Competent in activities required of peer reviewers Ready to complete site visits or provide TA/QA in accordance to Accreditation 1

3 The Essence of Quality Quality is never an accident; it is always a result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives. -William A. Foster 2

4 THE HFA INITIATIVE TODAY 444 programs in 43 states, D.C., U.S. territories and Canada Additional states and territories, plus expansion in existing states with federal MIECHV program 300+ leaders with expertise in QA, funding, PR, TA, training, etc. 385 or 95% of sites up-to-date and 95 sites currently in process 3

5 HFA REGIONAL & NATIONAL OFFICES Technical Assistance & Support Affiliation Accreditation Pre-site Development of the self study Intent of the standards Evidence examples Post-site Development of the response to the Preliminary Credentialing Report Deferral Celebrate! 4

6 HFA Regions Northeast Region, Region I: Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, Washington DC., West Virginia, Puerto Rico, and Us Virgin Islands. Southeast Region, Region II: Alabama, Florida, Georgia, Hawaii, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, Canada, Commonwealth of the Northern Mariana Islands Guam, and American Samoa. 5

7 HFA Regions (cont.) Central Region: Region III: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, Wisconsin Western Region, Region IV: Alaska, Arizona, Arkansas, California, Colorado, Idaho, Louisiana, Montana, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, 6

8 Contact Information: Regional Staff Northeast Region, Region I: – Lynn Kosanovich Southeast Region-Region II Kate Whitaker Central Region, Region III – Tracie Lansing Western Region, Region IV – Satya Kline 7

9 Contact Information: National Staff HFA National Office – Lisa Sutter – Training – Cydney Wessel – Site Visit Scheduling & Expense Reimbursements Phyllis Medrano –

10 DL Workbook & Analysis Activity Pull-out Assignment Workbook Sign and pass to the front pages 4 & 5 (Confidentiality and Principles of Behavior) Review Ratings – pages 6-10 Rating Standards that require monitoring, measuring and analyzing The distinction between these activities 9

11 Monitoring-Measuring-Analyzing Standards that Require Monitoring: 1-1.C, 1-1.E, 4-2.C, 6-4.B, 6-6.B, 7-4.B, 9-4, 10-1, GA-3, GA-9 Standards that Require Measuring: 1-1.D, 1-1.F, 1-2.A, 3-4.A, 4-1.B, 4-2.B, 7-1.B, 7-2, 11-1.B Standards that Require Analysis: 1-2.B/C and 3-4.B/C 10

12 SIMPLIFYING THE COMPLEXITIES OF ANALYSES Step 1: Measure utilize HFA methodology Step 2: Analyze includes required components: (comprehensive WDPS+F/I, comparative, correct timeframe) Step 3: Plan and implement Addresses findings from Step 2 11

13 ACTIVITY: Monitoring-Measuring-Analyzing 1)Review Sample 1-1 Data Tracking and assign ratings 2)Review Sample 1-2.A, B and C and assign ratings 3)Review Sample 3-4.A, B and C and assign ratings 4)Review Sample 9-4 and assign rating 12

14 FAQs What if the program defines enrollment date as date consent is signed vs. date of first home visit? Do all categories need to be completed on the analysis grids? Is the program out of adherence if the numbers dont seem to jive on the worksheets? 13

15 FAQs continued Is the program out of adherence if the retention percentage says invalid? Can programs enter all participants on the retention worksheet or just those from a particular year? Do we need to see back-up information on-site to verify the data on worksheets? Other Questions 14

16 FOUNDATION OF SELF-ASSESSMENT TOOL Based upon the critical elements & literature review Consensus and Research Based SAT forms minimum standards at which a program must function 12 critical elements & a section on governance and administration Elements 10 & 11 re: training are combined into standard 10 in SAT 15

17 FOUNDATION OF SELF-ASSESSMENT TOOL A series of inter-related standards Broadly organized by 1st order standards Similar to an outline 1. 1st Order Standard Initiate services prenatally or at birth nd Order Standard The program ensures it identifies families in the target population for services either while mother is pregnant (prenatally) and/or at the birth of baby. 1-1.A. 3rd Order Standard The program has a description of the target population that includes applicable demographic data and identifies places where the population is found (e.g., local hospitals, prenatal clinics, high schools, etc.). 1-1.B. 3rd Order Standard The programs system of organizational relationships with community entities (e.g. prenatal clinics, hospitals, etc.) allows families in the target population to be screened/identified to establish possible need for service. Each is a critical element, except for governance & administration section Form major components of 1st order standard Building blocks of system & forms basis of programs self-study 16

18 Unsupported Second Orders Are not broken down into two or more specific standards. Examples: 3-1. Services are offered to families on a voluntary basis The program offers home visitation services to families for a minimum of three years after the birth of the baby The program has a description of the cultural characteristics of its current service population, including ethnic, racial, linguistic, demographic and other characteristics. 17

19 TOOLS FOR MEASURING A PROGRAMS ADHERENCE STANDARD 7-3. Home visitors provide information, referrals, and linkages to available health care resources for all participating family members. INTENT: It is recommended that programs only provide information, referrals and linkages when necessary, (i.e., when a pregnant mother needs assistance connecting to prenatal care, or when parents or siblings have health concerns and are without a medical care provider). Therefore if a family is currently receiving necessary care, there may be no need for further provision of the above- mentioned services. EVIDENCE TABLE: Found in your folder Identifies policy & procedure requirements, additional pre-site evidence & on-site activities 18

20 TOOLS FOR MEASURING A PROGRAMS ADHERENCE RATING INDICATORS 3 = Program Exceeds the standard 2 = Program is meeting the standard 1 = Program is not adhering to the standard NA = Not applicable Tips:OPTIONAL!! Do not use Tips to determine adherence. 19

21 Where peers gather their information Program Self Study Participant File Review Other On-site Documentation Supervision Logs Meeting Minutes Personnel Records Training Logs Interviews Interviews – No this is not an accidental repeat. Electronic Surveys 20

22 UTILIZING THE ELECTRONIC SURVEYS SCAVENGER HUNT Using example survey summaries and SAT, work with partner 1 st Task: In 5 minutes, identify as many standards as possible that are inquired about in the surveys 2 nd Task: In 5 minutes, identify some areas of strength and some areas to further explore based on survey responses 21

23 Site Visit Simulation All materials presented are from Babyville, USA In your peer team, you will complete a peer review site visit from beginning to end All activities will build upon the previous activity And will result in a completed Accreditation Site Visit Report (SVR) 22

24 The Process Review the self study, develop preliminary ratings and develop interview questions Conduct a pre-site call w/co-peer Review & integrate the electronic surveys Review Participant Files Conduct an entrance meeting Further develop interview questions Interview program staff 23

25 The Process (cont.) Rate the standards Develop rationales for areas of non-adherence Conduct an exit meeting After each section, you will receive feedback regarding strengths and areas of growth. 24

26 PRE-SITE CALLS WITH FELLOW PEER Confirm travel arrangements Review each critical element Review self study standards Draft list of additional information needed Develop Pre-site ratings of adherence only Draft interview questions 25

27 DURING THE TEAM COORDINATORS CALL WITH PROGRAM LEADERSHIP Discuss travel arrangements Develop the interview schedule Identify formal and casual culture Discuss omissions in the Self Study Review site visit activities & sampling methods Ask for any updates 26

28 PARTICIPANT RECORD REVIEW Peers select records Use a participant roster to select a representative sample Across home visitors Across levels of service Across length of time in the program (age of child) Review a minimum of 3 records per home visitor for programs with 1-7 staff 27

29 REVIEWING ADDITIONAL RECORDS Creative outreach - Closed As needed to determine rating, when: there are inconsistencies new or changed policies or practices peers judgment Keep in mind you need only review documentation for selected standards 28

30 PARTICIPANT FILE CHECKLIST Identifies standards that require file review Helps quantify record review Makes review more consistent & less subjective Peers should: Use dates where possible Include size of active caseload Create a key for PCA America staff Identify name at top of form & submit with Preliminary Credentialing Report 29

31 OTHER ON-SITE DOCUMENTATION Training logs Supervision records (logs, notes, etc.) Personnel records (specific to standards) Minutes of organizing body meetings Any documentation that is evidence of adherence to standards (use documentation checklist as guide), especially documentation not submitted with self-study & forms, policies, etc., that have been modified since completion of self-study 30

32 ENTRANCE MEETING Meet each other 30 minute agenda Put program staff at ease Discuss the activities for the next two days Avoid disclosing the number of peer reviews you have completed 31

33 ENTRANCE MEETING AGENDA Thank attendees Make brief introductions Overview of HFA accreditation process & purpose of accreditation Review what the site has already accomplished Describe on-site activities Answer questions the site might have Review confidentiality/anonymity 32

34 INTERVIEWING ESSENTIALS Come prepared Create a welcoming environment Ask effective questions Follow-up responses with additional questions as necessary Ask clarifying questions before assigning a 1 rating Behavioral interviews 33

35 COME PREPARED Know what you want to achieve Organize questions around the background of the interviewee Review the standards that are interview paradigms Use listener responses, files and standards as points of reference 34

36 STARTING THE INTERVIEW Typically 30 minutes for staff (15 for families) Introduce self Thank interviewee Assure confidentiality Ask permission to take notes Acknowledge strengths 35

37 WHAT IS AN INTERVIEW PARADIGM? There are a number of standards are interview paradigms Standards that focus on process versus documentation Build follow- questions on interviewees responses Ask interviewees to illustrate process using files Example: trust building activities (standard 3-2.B) 36

38 RATING INTERVIEW PARADIGMS Documentation is sufficient for continuation of services Interviews are consistent across multiple staff roles Families concur that practice is occurring in the field (when appropriate) 37

39 WRITING RATIONALES What is the ultimate purpose of the rationale? To prove lack of adherence or to motivate improvement? Be detailed, specific, factual Reference: Self-study File Review Interviews Other documentation 38

40 WRITING RATIONALES Provide link to intent of the standard Keep tone objective What we write is just as important, if not more important, than what we say Put yourself in the programs shoes - no surprises please 39

41 WRITING RATIONALES Who is the audience? The program HFA National staff The HFA Accreditation Panel Importance of the details Expect technical support & assistance Writing strengths & recommendations 40

42 EXIT MEETING Commend program for hard work and congratulate on commitment to providing services consistent with HFA best practice standards Overview meeting agenda Summarize team findings addressing each critical element: Strengths Challenges Recognize recent practice changes Cite positive comments from families 41

43 EXIT MEETING (cont.) Provide opportunity to clarify and emphasize that program can still provide evidence as appropriate Review next steps and decision making process Receipt of SVR (4 weeks) Consultation with national/regional office Development of plan to complete the credentialing process Solicit questions & comments Thank site for hospitality and cooperation during visit 42

44 Correspondence with National Request to sign up for a site visit Confirmation Letter Technical Assistance & Support Travel Arrangements & Hotel Reimbursements Feedback to fellow peer & process Submission of paperwork/checklists 43


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