1. QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010 Reviewing & Refining Our Practice: Applying Disciplined Inquiry to Case Practice to Improve Results Reviewing & Refining Our Practice: Applying Disciplined Inquiry to Case Practice to Improve Results

2. What is QSR? The Quality Service Review (QSR) provides ways of knowing what’s working and not working at the practice points for which children and families and why. QSR tests the PRACTICE MODEL used in actual cases. QSR connects results to local FRONTLINE CONDITIONS. QSR supports teaching & action learning processes that clarify expectations, provide useful feedback, and affirm good work. QSR stimulates actions taken to improve practice and results at all levels of the organization. QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010

3. How Does QSR Work? Uses in-depth CASE REVIEWS to measure current status, recent progress, and adequacy of current practices in getting results for children and families being served in local sites. [Drill Downs] Uses the POWER FOR STORY to reveal what is happening and working for families at the practice points. [Stories Teach] Uses aggregate quantitative PATTERNS of qualitative indicators to reveal and describe the quality and consistency of local practice. Uses local focus group and key stakeholder interviews along with case stories, data patterns, and local working conditions to find and affirm what’s working now and to surface areas where even better results might be achieved in the future. QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010

4. 8 COORDINATING, INTEGRATING, COLLABORATING Core Functions in Child & Family Practice 1 3 4 5 6 7 2 ENGAGING Family Members/ Assemble Family Team/ Begin TEAMING Processes ASSESSING & UNDERSTANDING the Current Situation -- Strengths, Needs, Underlying Issues PLANNING Outcomes for Safe Case Closure, Change Strategies, Actions, and Resources RESOURCING Planned Intervention Strategies, Actions, and Supports INTERVENING by Using Treatment Strategies, Supports, and Transitions TRACKING Progress, Results, What’s Working; Maintaining Situational Awareness ADAPTING Services Through On-going Assessment and Planning Key Functions in a Our Practice Model ELIGIBLE CHILD & FAMILY => ENTRY SAFE CASE CLOSURE OUTCOMES MET => EXIT 9 QSR Tests Basic Practice Functions Leading Practice Development © Human Systems & Outcomes, Inc., 2010 1

5. Possible Indicators in a QSR Protocol 1. Engagement 2. Teamwork 3. Assessment & understanding 4. Long-term view / family outcomes 5. Planning a change process – A. Safety management – B. Permanency 6. Necessary resources 7. Intervention adequacy 8. Tracking & adjusting 1. Engagement 2. Teamwork 3. Assessment & understanding 4. Long-term view / family outcomes 5. Planning a change process – A. Safety management – B. Permanency 6. Necessary resources 7. Intervention adequacy 8. Tracking & adjusting 1. Cultural competence 2. Transitions & life adjustments 3. Medication management 4. Crisis management OVERALL PRACTICE PERFORMANCE 1. Cultural competence 2. Transitions & life adjustments 3. Medication management 4. Crisis management OVERALL PRACTICE PERFORMANCE Optional Specialized Practices Limited, Situational Use Limited, Situational Use Optional Specialized Practices Limited, Situational Use Limited, Situational Use Core Practice Functions Applicable for All Families Applicable for All Families Core Practice Functions Applicable for All Families Applicable for All Families QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010

7. Useful Reporting For Monitoring EXIT CRITERIA QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010

8. How Does QSR Stimulate Change? Promotes and applies the practice model to actual cases to measure progress and results. Links results to frontline conditions at local practice points. Finds and affirms good practice in actual cases. Tracks progress toward meeting performance goals Provides immediate, safe, and useful feedback to practitioners. Uses grand-rounds sessions to teach from cases reviewed about what’s working now and what to do next. Stimulates local supervisors and managers to take next steps and enables effective use of technical assistance. QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010

9. QSR Activities in 2010 January: QSR overview for key participants February: Design team process March: Protocol design & development April: Technical review and recommendations May: Protocol refinements, training preparation June: QSR reviewer training & pilot testing July: QSR refinements August: Second QSR training & site review QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010

10. Let’s Talk! QSR/Practice Overview © Human Systems & Outcomes, Inc., 2010