Post on 17-Dec-2015
transcript
Continuous Quality Improvement: Ideas from The Field
Becca Sanders, Carolyn SullinsEvaluators, Kalamazoo Wraps System of Care beccaanddan@gorge.net; csullins@wmich.edu
Objectives
From Theory to Practice in the Field• Challenges to implementing the model• Reorienting Evaluation
– Onlooker vs. In the Mix– CQI: “The Big 3” to be Tackled– Technical and Adaptive Components
How CQI? • Our “Non-model Model”
– New roles for evaluators– The Foundation: Key Components– What Matters– What Does it Look Like?
Model Challenges: CQI in an SOC Context
The Scope of SOC • Not a program The Scope of the SOC Audience• Relevance, right people at the right table- not so easyThe SOC Aggregate Data Only Problem• Moving target, changing system The Nature of the SOC Problem • Technical and adaptive problems require technical and
adaptive solutions
CQI looks good on paper:Moving from paper to action…It’s another story…What are the barriers?
“Check out our tight indicators and efficient quarterly review process… yeah… we’ll work on that…”
More Model Challenges:CQI in an SOC Context
Most SOCs Already Have:• Data demands from other
agencies• Plenty of (inconsistently
collected, underutilized) data• Concerns about how data
may be misinterpreted• Skepticism about the
usefulness of more data
Reorienting Evaluation: A Key Shift for Doing CQI Well
Data as “beside” the (systems) problem; a contributor to the solution.
• Help figure out if good “stuff” is happening in an initiative.
• If not, why not?• If not, what should we
do about it?• Clean, linear, solid
aggregate indicators
Data as “within” the (systems) problem; a contributor to the problem (and solution).
• Data culture chronically nonfunctioning or nonexistent.
• Data culture in need of CQI in and of itself.
• “Readiness for CQI:” Precedes all else
Reorienting Evaluation Onlooker vs. In the Mix for a Fix
Evaluation of Change EffortsMultiple Change Efforts
Practices/ Services
Procedures
Policies
Etc…
Multiple Change Efforts
Practices/ Services
Procedures
Policies
Etc…
Data Culture
Onlooker
In the Mix for a Fix
Does the data stuff…vs.
Helps us do the data stuff
What does Reorientation Look Like?CQI: “The Big 3” To Be Tackled
1) Data Existence: Collect relevant, useful data, consistently and accurately. Simplify this process!
2) Data Access: MIS system extraction, MIS data input, resources, expertise, power structures, trust, bureaucratic structures, agency culture, regulations, interest/ competence levels, data silos, data sharing agreements, understanding.
3) Data Dissemination: report on time, clearly and simply, link to individuals when appropriate, level “local” enough to be helpful.
When ducks in a row, data use follows
CQI: The Big Picture OutcomeBig Picture Outcome: Build a data-guided culture
across organizations/ stakeholders by helping communities improve “The Big 3:”
1.Data Existence
2.Data Access
3.Data Dissemination
A Mix of Technical and Adaptive Issues
See ya’ll in 10 years… this is going to take me a while.
Technical versus Adaptive
What do we mean?Technical: “WHAT there is to know.”
• Requires a knowledge transfer• The “teachables”
Adaptive: “WHY this is important.” “HOW you can use it.”
• Requires a value shift• The “less-teachables”
“The Big 3:” Require a Mix of Technical and Adaptive Solutions
Welcome to the Kalamazoo Wraps luxury!Hi! I’m an evaluator… I focus mostly on the adaptive stuff related to building a data guided culture: coaching, working one on one with stakeholders, helping people understand the value of data, upping interest and engagement in data related activities, making sure people understand reports and that they’re pretty. My budget is small.
Hi! I’m an evaluator… I focus mostly on the technical stuff related to building a data guided culture- collecting data, creating and managing databases, analyzing data, helping create and review instrumentation. I also run the national evaluation. My budget is large.
Hey… lets support one another’s roles!
Strategies for CQI Capacity BuildingTechnical and Adaptive Solutions
The Big 3 Highly Technical Highly Adaptive
Data
Existence
Data
Access
Data Dissemination
CoachingInstrument Review and Recommendations
Help with MIS systems set up
Data Collection
Technical Assistance
MIS system access
Analysis
Data management
MOU establishment with partnering organizations
Catered Reporting•Content•Timing•Stakeholder driven•Data splits
Product Review
CQI: What Matters?The Foundation: Key Components
• Initiative/ Leadership: Who Cares?
• Relationship building/ personality: What’s the engagement / hook
• Data splits for targeted responsesBy clinician, by individual…
• Fluidity: Product, Timing, Whose at the TableTweak, Tweak and Tweak some more
Beware of polite toleration of CQI efforts! (Adaptive)
Offer a service!(Adaptive)
Aggregate lacks utility! (Technical)
pi= 3.141592653…and on it goes (Adaptive and Technical)
CQI: What Can it Look LikeA “Close Proximity” Family Vacation:
A few key people have a vague notion of the kind of place they want to go…
So they hop in the car…
But there’s no map…
So you get lost…
But you know enough to get found…
Then you arrive…
At something close to what you were going for…
But you swear there are measures you can take so next year will be better…
So you start planning…
Then you hop back in the car…
If You Give a Mouse a Cookie…
In Conclusion
• Foundation/ key components to quality CQI- clear• Various facets of the CQI problem- clear• Various facets of the CQI solution- clear• Roles/ who does what regarding CQI- clear
• How to apply CQI: (intentionally) not so clear. Why?– fluid– catered– responsive– highly localized
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