Guide to theColorado Practice Model (CPM) County Implementation ProcessFor Quality Practice Team (QPT) Leaders & State Implementation Specialists (SIS)Introduction
Purpose of this Guide This guide is designed to assist you in implementing the Colorado Practice Model (CPM) in your county. Pages 3-8 provide a general level of knowledge regarding the CPM and the remainder of the guide steps your county QPT through a typical continuous quality improvement process (CQI) from start to finish. Starting on page 9, the guide is divided into QPT meetings 1-9. The work of each meeting is cumulative; each meeting’s success is dependent upon the completed work of the previous meeting (including between meeting homework). The products of each meeting (the items with a red star marked on them) will become the material for your QPT’s presentation to the Promising Practices Workgroup (PPWG) when they submit a proposal at the end of each CQI cycle. So don’t forget to save every piece of work your QPT does! Before you begin implementation, your QPT will have had an introduction to continuous quality improvement. In addition, each QPT leader and State Implementation Specialist (SIS) has been provided with a handbook of CQI methods and tools entitled “The Quality Toolbox (2nd Ed.)”. Proper use of these methods and tools is essential to success. Please do not minimize the importance of these tools for the sake of completing the task; they have important theoretical underpinnings in team building and group process. Please maintain the fidelity of CQI tools and methods in the work that you do with your QPT, even if you have to delay progress in the implementation process. Using this guide, your State Implementation Specialist (SIS) will work with you to help you with what is required of each meeting and to assist you in the cumulative work your QPT has to produce during each CQI cycle. If you have any questions about this guide, contact your SIS; he or she will help you with the answer. In addition, when planning your QPT meetings, talk to your SIS; he or she will help you be successful in conducting your meetings. Now let’s begin with an introduction.
Culture “The blend and sharing of values, beliefs, norms, and actions that have a reciprocal long-term effect on organizational performance, employee morale, and client outcomes.”
Continuous Quality Improvement The process of identifying, analyzing, and modifying business processes so as to increase the effectiveness and/or efficiency of programs and services to the client.
Collaboration • Teamwork • Partnership • Group Effort • Association • Alliance • Relationship • Cooperation • Supervision
Consensus “Collective opinion or concord; general agreement or accord.” 9.5 10 10 10
The Goal of the CPM The goal of the CPM is to collaboratively design, develop, implement, and evaluate a State and county wide consensus-based child welfare best practice model that continuously improves child and family outcomes by June 2015.
1. Introduce the CPM and Define Team Goals, Roles, and Working Relationships 2. Reconcile Agency and CPM Vision, Mission, and Values 3. Examine Best Practices and Those In Need of Improvement Start 6. Examine Causes and Cause-Effect Relationships Prioritize Opportunities for Improvement 4. Map your Best Practices and Those In Need of Improvement 5. Conduct Cause-Effect Analysis Continuous Quality Improvement Loop 7. Identify & Prioritize Possible Improvement Strategies. Select Best Strategy. 8. Develop and Write Improvement Strategy Action Plan 9. Present Proposal and Action Plan to Your Management Team The Whole Implementation Process (Concept by Concept)
Who Conducts this Process? • The QPT Leader conducts this process • With the Help of the Implementation Team Specialists • The Implementation Team Specialists consults with the QPT Leader to help him/her learn and conduct the process. • The Implementation Team Specialists assist in monitoring the implementation process to ensure it is done with fidelity • The Implementation Team Specialists ensure that all necessary materials are available for the meeting • The Implementation Specialists makes sure to bring all completed forms in this process back to the QPT and the Child Welfare Division.
Deliverables Expected • At least every 6 months, each QPT will develop and present a proposal for improving processes that will result in a significant improvement in programs or services or… • At lease every 6 months, each QPT will present a proposal for a Promising Practice. • Each proposal will be reviewed, modified, approved by: • County Child Welfare Management • The Promising Practices Workgroup • Each approved proposal will be provided the necessary resources to implement the changes required to improve program/service processes or it will become a resource for other counties to access to improve their programs/services (I.e. promising practice)
We Will Now Review Each Meeting • Meeting 1: A CPM Introduction • Meeting 2: Reconciling Vision, Mission, and Values • Meeting 3: Promising Practices & Opportunities for Improvement • Meeting 4: Mapping Your Practice • Meeting 5: Conduct Process Cause-Effect Analysis • Meeting 6: Examine the Causes and Cause-Effect Relationships and Prioritize Opportunities for Improvement • Meeting 7: Identifying & Prioritizing Strategies for Improvement • Meeting 8: Writing the Improvement Strategy Action Plan • Meeting 9: Preparing Your Management Presentation
Quality Practice Team Meeting 1: A CPM Introduction
Purpose of this Meeting In this meeting your QPT will 1) review the Colorado child welfare practice model, and 2) make decisions on QPT membership and norms.
Agenda • Welcome and introductions • Colorado Practice Model Logo • A little bit-o-history • Goal of CPM • Expected outcomes • The “base” practice model • Structure of CPM • The Role of the QPT • Membership Expectations • QPT Norm Setting • Elect Leader • Choose Roles
Can You See Our Values in Our Logo? • Safety • Child Centered • Family Focused • Culturally Responsive • Collaborative • Competent • Communicative
The Goal of CPM To collaboratively design, develop, implement, and evaluate a State and county wide consensus-based child welfare best practice model that improves child and family outcomes by June 2015.
Executive Oversight Committee Review Advise Monitor Delegate Guide Coordinate Decide Project Operations and Implementation Team Systems of Care PM Design and Development Work Group Family Engagement Family Engagement Design Develop Recommend Implement Evaluate Policy, Rules, Procedures Work Group Communication Work Group Performance Management Work Group Colorado Practice Model Systems of Care Systems of Care Education Work Group Evaluation Work Group Family Engagement Family Engagement Implementation Workgroup Financial Work Group Promising Practices Workgroup Systems of Care Continuous Quality Improvement Work Group Rewards and Recognition Work Group The Structure of CPM
Expected Outcomes Promising Practices In Colorado • Compendium of Promising Practices in Colorado • This product will enable all counties to access and adopt promising practices from other counties and incorporate them into their own practice framework. • A Peer Built and Maintained Practice Culture • A Child Welfare Community that Continuously Learns and Improves Services
The Base Practice Model • Handout, read (20 minutes), review, comments? • Foundation of Colorado’s child welfare practice • Values, Vision, Mission • Standards of Practice • Practice Phases & Indicators • Outcomes! • Promising Practices!
The Role of the QPT The county Quality Practice Team is the primary group building the Colorado Practice Compendium. This group will 1) document county child welfare practices, 2) identify promising child welfare practices, and 3) identify practice areas needing improvement. The QPT will accomplish this through the use of continuous quality improvement methods and tools. Upon completion of their tasks, the QPT will present proposals for promising practices or areas needing improvement to the Colorado Promising Practices Workgroup. This process will continue throughout the life of the QPT in each and every county.
Membership Expectations • Meet regularly (at least once per month for 2-3 hours). Preferably once every other week. • Do work in-between meetings (data collection, formatting, analysis, graphics, etc.) • Attend all meetings and participate openly, encourage others to participate • Learn and apply the principles of continuous quality improvement • Assist in identifying promising practices and areas in need of improvement • Participate in developing proposals for review by the Colorado Promising Practices Workgroup • Commit to at least 1 year of service on the QPT
Elect Your Leader (if none is assigned) • Let’s use NGT (nominal group technique) to identify who might be the leader of this QPT! • Everyone gets a index card. • Write 3 names of nominees on your card in order of first choice to last. • Fold your card twice and give it to the facilitator. • Facilitator lists names on newsprint • Facilitator records the # of times each name is listed. • Member with highest # of times name listed becomes elected leader. • Ties settled by secret ballot!
QPT Norm Setting • Let’s use round-robin brainstorming to set some norms for our QPT • What are the rules for RRB? • Example: “Start and end meetings on time” or “no interrupting!” or “Do your homework on time” etc. • What other norms do you want to list? • Let’s hang our norms on the wall at every meeting!
Let’s Give QPT Members Roles • Who is our time manager? • Who is our recorder? • Who is our group processor? • Who is our gate keeper? • Who is our minute taker?
QPT Charter Team Name:__________________ Leader & Member Names QPT Purpose: Norms
End of Meeting • If your QPT successfully reviewed the Colorado child welfare practice model and made decisions on QPT membership and norms. • Schedule your next meeting • Confirm who will attend. • Facilitators gather up and save all newsprint and materials.
Quality Practice Team Meeting 2: Reconciling Vision, Mission, and Values
Purpose of this Meeting To reconcile your county child welfare department’s Vision, Mission, and Values with those of the Colorado Practice Model.
Today’s Agenda • Welcome and Introductions • Review of County Child Welfare Vision, Mission, Values • Review of Colorado Practice Model Vision, Mission, and Values • Review of Colorado Practice Model Standards, Skills, and Outcomes • Process Reconciliation of Agency and CPM Values, Vision, and Mission • Welcome and Introductions • Review of County Child Welfare Vision, Mission, Values • Review of Colorado Practice Model Vision, Mission, and Values • Review of Colorado Practice Model Standards, Skills, and Outcomes • Process Reconciliation of Agency and CPM
Review County Vision, Mission, Values • Distribute county child welfare vision, mission, values to QPT members. • Ask QPT members to take 20 minutes to read and think about this material. • Ask QPT members to Take 10 minutes to jot down a few key words or concepts that they found particularly important in their county’s vision, mission, values. • Discuss the meaning of this material among the QPT members. • Develop one list of key words or concepts that represents a consensus among the QPT members. • Fill out the first column in the table on the next page.
Review CPM Vision, Mission, and Values • Distribute Colorado Practice Model vision, mission, values to QPT members. • Ask QPT members to take about 20 minutes to review this material. • Ask QPT members to take 10 minutes to jot down a few key words or concepts that they found particularly important in the CPM vision, mission, values. • Discuss the meaning of this material among the QPT members. • Develop one list of key words or concepts that represents a consensus among the QPT members. • Fill out the second column in the table on the next page
Our Mission, Vision, Values • Let’s compare our county’s MVV with the CPM’sMVV. • Does our county’s MVV match (not exactly, but close enough) the CPM’s MVV? • In the table on the next page compare the county and CPM key words and concepts. In the third column, write in an “S” if the concepts are the same, write in an “R” if the concepts are related, and write in a “U” if the concepts are unique. • Do we have a QPT consensus thatthecounty and CPMMVV’smatch? (really?) OK, let’s go on.
Construct a Customer Service Statement • Now that you have reached a consensus that there is a close enough match between the county and CPM vision, mission, and values… • Let’s construct a customer service statement to communicate to our children, youth, and families what they can expect from us as far as our service to them is concerned. • Lets start with the vision, mission, and values… • Then we will add our own promise statements to the list • When we have a consensus about our promise statements we will have the philosophy and statements formatted and hung in our unit.
Brainstorm Promise Statements • Let’s brainstorm a list of statements that reflect our vision, mission, and values and tell our clients what to expect from us. • Write them down on chart paper as we go. • Combine them when we are finished brainstorming. • About 10-15 statements will be enough for us to tell our clients what to expect from us regarding how we will work with them. • Lets do the brainstorming now!
In _____ County we believe…(Example) Vision ___________ children and youth have the opportunity to thrive in safe, nurturing, and stable families within their communities. Mission The ____________child welfare system, in partnership with families and communities, will protect children and youth by striving to achieve their safety, permanency, and well being. Values Our values are child and youth safety, child centered, family focused, collaborative partnerships, cultural responsiveness, competence, and good communications. Promises We promise to… • Treat you with respect and caring at all times • Greet you and call you by name when we are working with you • Etc. • Etc.
Where will we display our Statement? • On the door? In the hallway? At the elevator? • Let’s brainstorm the possible places we could display our customer service statement. • From this list of possible places, let’s decide which is the best. • Do we have a consensus on this decision? • Your implementation team member will collect the statement from your QPT and have it formatted for you agency.
End of Meeting • If your QPT successfully matched your county MVV’s with those of the CPM and you have agreement on the formatting and location of the MVV’s, then you are finished with your first meeting. • Schedule your next meeting • Confirm who will attend. • Facilitators gather up and save all newsprint and materials.
Quality Practice Team Meeting 3: Promising Practices & Opportunities for Improvement
Purpose of This Meeting In this meeting your QPT will examine county data to identify potential promising practices and opportunities for improvement in child welfare in your county.
Agenda • Welcome and introductions • Handout and review data report • In general, what does the State data say? • What does our county data tell us? • What are our 3 biggest strengths; what are our 3 biggest opportunities for improvement? • Gap Analysis • Where do we want to start: pick one strength or opportunity for improvement • Homework
Review the Data Report • Distribute/explain contents of data handbook • Review State level data: What do these data tell us about our child welfare system? • Review/analyze/discuss county specific data; what do these data tell us about our county? • Brainstorm/record facts that the data reveal about the county • Check out the validity of those facts by asking QPT members to comment on their perceptions (e.g. Child protection assessments closed within 120 days)
State Scorecard • Examine the State Scorecard. • What do all these numbers mean? • As a State, how can we tell if we are (are not) doing well? • Discuss how well the State is doing on each outcome measure. • Come to a consensus about the 3 highest outcome scores and the 3 lowest outcome scores. Does everyone agree? • Which outcome scores indicate potential best practices (BPs) and which indicate opportunities for improvement (OIs)? • Any other observations from this data? • Now let’s look at your county scorecard.
County Scorecard • Examine the County Scorecard. • What do all these numbers mean? • As a county, how can you tell if you are (are not) doing well? • Discuss how well your county is doing on each outcome measure. • Come to a consensus about the 3 highest outcome scores and the 3 lowest outcome scores. (e.g.. construct a Pareto chart of averages). Do you all agree? • Your 3 highest outcome scores could indicate best practices (BPs); your 3 lowest outcome scores could indicate opportunities for improvement (OIs). • Select 1 BP and 1 OI to start your CQI journey
Gap Analysis • How far are you from the federal goal on the outcome measures you chose? • Compare your “Total” outcome score on each measure with the corresponding federal goal. • The difference is how far you have exceeded or missed the goal. • Hint: You may choose other approaches to analyzing the Gap! • Let’s say the outcome measure where you exceed expectations contains a potential “best practice” (BP). • Let’s say the outcome measure where you missed the goal contains a potential “opportunity for improvement” (OI).
Programs & Services • Let’s identify the program(s) and/or service(s) we believe directly influence your potential BP or OI outcome (Round-robin brainstorming?). • Record your programs and services on chart paper for your BP and OI. • Let’s look at an example of each on the following slides. CLIENT