Presentation on theme: "What To Expect Out of the Training"— Presentation transcript:
0 HFA Peer Reviewer & TA/QA Training June 18 - 20, 2012 Fort Wayne, IN Kate Whitaker, Tracie Lansing
1 What To Expect Out of the Training Grounded in a CQI philosophyUnderstand the Site Visit ProcessCompetent in activities required of peer reviewersReady to complete site visits or provide TA/QA in accordance to Accreditation
2 -William A. Foster 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
3 THE HFA INITIATIVE TODAY 444 programs in 43 states, D.C., U.S. territories and CanadaAdditional states and territories, plus expansion in existing states with federal MIECHV program300+ leaders with expertise in QA, funding, PR, TA, training, etc.385 or 95% of sites up-to-date and 95 sites currently in process
4 HFA REGIONAL & NATIONAL OFFICES Technical Assistance & SupportAffiliationAccreditationPre-siteDevelopment of the self studyIntent of the standardsEvidence examplesPost-siteDevelopment of the response to the Preliminary Credentialing ReportDeferralCelebrate!
5 HFA RegionsNortheast 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.
6 HFA Regions (cont.)Central Region: Region III: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, WisconsinWestern Region, Region IV: Alaska, Arizona, Arkansas, California, Colorado, Idaho, Louisiana, Montana, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming,
7 Contact Information: Regional StaffNortheast Region, Region I: –Lynn KosanovichSoutheast Region-Region IIKate WhitakerCentral Region, Region III –Tracie LansingWestern Region, Region IV –Satya Kline
8 Contact Information: National StaffHFA National Office –Lisa Sutter – Training –Cydney Wessel –Site Visit Scheduling & Expense ReimbursementsPhyllis Medrano –
9 DL Workbook & Analysis Activity Pull-out Assignment WorkbookSign and pass to the front pages 4 & 5 (Confidentiality and Principles of Behavior)Review Ratings – pages 6-10Rating Standards that require monitoring, measuring and analyzingThe distinction between these activities
10 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
11 SIMPLIFYING THE COMPLEXITIES OF ANALYSES Step 1: Measureutilize HFA methodologyStep 2: Analyzeincludes required components: (comprehensive WDPS+F/I, comparative, correct timeframe)Step 3: Plan and implementAddresses findings from Step 2
12 ACTIVITY: Monitoring-Measuring-Analyzing Review Sample 1-1 Data Tracking and assign ratingsReview Sample 1-2.A, B and C and assign ratingsReview Sample 3-4.A, B and C and assign ratingsReview Sample 9-4 and assign rating
13 FAQ’sWhat 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 don’t seem to jive on the worksheets?
14 FAQ’s continuedIs 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
15 FOUNDATION OF SELF-ASSESSMENT TOOL Based upon the critical elements & literature reviewConsensus and Research BasedSAT forms minimum standards at which a program must function12 critical elements & a section on governance and administrationElements 10 & 11 re: training are combined into standard 10 in SAT
16 FOUNDATION OF SELF-ASSESSMENT TOOL A series of inter-related standardsBroadly organized by 1st order standardsSimilar to an outline1. 1st Order StandardInitiate services prenatally or at birth.nd Order StandardThe 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 StandardThe 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 StandardThe program’s 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 sectionForm major components of 1st order standardBuilding blocks of system & forms basis of program’s self-study
17 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.4-3. The program offers home visitation services to families for a minimum of three years after the birth of the baby.5-1. The program has a description of the cultural characteristics of its current service population, including ethnic, racial, linguistic, demographic and other characteristics.
18 TOOLS FOR MEASURING A PROGRAM’S ADHERENCE STANDARD 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
19 TOOLS FOR MEASURING A PROGRAM’S ADHERENCE RATING INDICATORS3 = Program Exceeds the standard2 = Program is meeting the standard1 = Program is not adhering to the standardNA = Not applicableTips: OPTIONAL!! Do not use Tips to determine adherence.
20 Where peers gather their information Program Self StudyParticipant File ReviewOther On-site DocumentationSupervision LogsMeeting MinutesPersonnel RecordsTraining LogsInterviewsInterviews – No this is not an accidental repeat. Electronic Surveys
21 UTILIZING THE ELECTRONIC SURVEYS SCAVENGER HUNTUsing example survey summaries and SAT, work with partner1st Task:In 5 minutes, identify as many standards as possible that are inquired about in the surveys2nd Task:In 5 minutes, identify some areas of strength and some areas to further explore based on survey responses
22 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 endAll activities will build upon the previous activityAnd will result in a completed Accreditation Site Visit Report (SVR)
23 The ProcessReview the self study, develop preliminary ratings and develop interview questionsConduct a pre-site call w/co-peerReview & integrate the electronic surveysReview Participant FilesConduct an entrance meetingFurther develop interview questionsInterview program staff
24 The Process (cont.) Rate the standards Develop rationales for areas of non-adherenceConduct an exit meetingAfter each section, you will receive feedback regarding strengths and areas of growth.
25 PRE-SITE CALLS WITH FELLOW PEER Confirm travel arrangementsReview each critical elementReview self study standardsDraft list of additional information neededDevelop Pre-site ratings of adherence onlyDraft interview questions
26 DURING THE TEAM COORDINATOR’S CALL WITH PROGRAM LEADERSHIP Discuss travel arrangementsDevelop the interview scheduleIdentify formal and casual cultureDiscuss omissions in the Self StudyReview site visit activities & sampling methodsAsk for any updates
27 PARTICIPANT RECORD REVIEW Peers select recordsUse a participant “roster” to select a representative sampleAcross home visitorsAcross levels of serviceAcross length of time in the program (age of child)Review a minimum of 3 records per home visitor for programs with 1-7 staff
28 REVIEWING ADDITIONAL RECORDS Creative outreach - ClosedAs needed to determine rating, when:there are inconsistenciesnew or changed policies or practicespeers’ judgmentKeep in mind you need only review documentation for selected standards
29 PARTICIPANT FILE CHECKLIST Identifies standards that require file reviewHelps quantify record reviewMakes review more consistent & less subjectivePeers should:Use dates where possibleInclude size of active caseloadCreate a key for PCA America staffIdentify name at top of form & submit with Preliminary Credentialing Report
30 OTHER ON-SITE DOCUMENTATION Training logsSupervision records (logs, notes, etc.)Personnel records (specific to standards)Minutes of organizing body meetingsAny 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
31 ENTRANCE MEETING Meet each other 30 minute agenda Put program staff at easeDiscuss the activities for the next two daysAvoid disclosing the number of peer reviews you have completed
32 ENTRANCE MEETING AGENDA Thank attendeesMake brief introductionsOverview of HFA accreditation process & purpose of accreditationReview what the site has already accomplishedDescribe on-site activitiesAnswer questions the site might haveReview confidentiality/anonymity
33 INTERVIEWING ESSENTIALS Come preparedCreate a welcoming environmentAsk effective questionsFollow-up responses with additional questions as necessaryAsk clarifying questions before assigning a “1” ratingBehavioral interviews
34 COME PREPARED Know what you want to achieve Organize questions around the background of the intervieweeReview the standards that are interview paradigmsUse listener responses, files and standards as points of reference
35 STARTING THE INTERVIEW Typically 30 minutes for staff (15 for families)Introduce selfThank intervieweeAssure confidentialityAsk permission to take notesAcknowledge strengthsThis applies to interviewees who were not present at the Entrance meeting.
36 WHAT IS AN INTERVIEW PARADIGM? There are a number of standards are interview paradigmsStandards that focus on process versus documentationBuild follow- questions on interviewee’s responsesAsk interviewees to illustrate process using filesExample: trust building activities (standard 3-2.B)
37 RATING INTERVIEW PARADIGMS Documentation is sufficient for continuation of servicesInterviews are consistent across multiple staff rolesFamilies concur that practice is occurring in the field (when appropriate)
38 WRITING RATIONALES What is the ultimate purpose of the rationale? To prove lack of adherence or to motivate improvement?Be detailed, specific, factualReference:Self-studyFile ReviewInterviewsOther documentation
39 WRITING RATIONALES Provide link to intent of the standard Keep tone objectiveWhat we write is just as important, if not more important, than what we sayPut yourself in the program’s shoes - no surprises please
40 WRITING RATIONALES Who is the audience? The program HFA National staff The HFA Accreditation PanelImportance of the detailsExpect technical support & assistanceWriting strengths & recommendations
41 EXIT MEETINGCommend program for hard work and congratulate on commitment to providing services consistent with HFA best practice standardsOverview meeting agendaSummarize team findings addressing each critical element:StrengthsChallengesRecognize recent practice changesCite positive comments from families
42 EXIT MEETING (cont.)Provide opportunity to clarify and emphasize that program can still provide evidence as appropriateReview next steps and decision making processReceipt of SVR (4 weeks)Consultation with national/regional officeDevelopment of plan to complete the credentialing processSolicit questions & commentsThank site for hospitality and cooperation during visit
43 Correspondence with National Request to sign up for a site visitConfirmation LetterTechnical Assistance & SupportTravel Arrangements & HotelReimbursementsFeedback to fellow peer & processSubmission of paperwork/checklists
44 CONGRATULATIONS!!!!!!!TRAINING IS COMPLETE, WE NOW DEEM YOU PROVISIONARY HFA PEER REVIEWERS!!REMEMBER TO GET YOUSELF ON THE SITE VISIT CALENDAR.Evaluations will be sent to you electronically!!!