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Course – Lesson 2: II. Concepts

CONCEPTS
TERMS TO EXPLORE

LESSON 2:II – WHAT ARE KEY CONCEPTS AND TERMS TO EXPLORE?

INTRODUCTION TO THE ASSESSMENT PHASE OF CQI

In this session we will explore the data-informed continuous quality improvement (CQI) process and focus on the first phase: assessment.

The lesson supports using data to understand the local community “systems of safety and care” to provide insights into problems and solutions.

ABOUT DATA AND THE ASSESSMENT PHASE

Throughout the assessment phase, data allow us to identify and describe the populations we serve, our clients and identify priority areas. Data also allow us to identify specific challenges related to ACEs, maltreatment and trauma. Data also reveal upward or downward trends in rates.

Data allow us to identify the capacity of a local office and/or community to achieve short, intermediate and long term goals. With the identification of challenges, we can begin to identify root causes of ACEs, trauma and maltreatment. You’ll find an overview of root causes in Anna, Age Eight, chapter 4: Our inheritance of horrors: The complex, chaotic, and invisible root causes of trauma.

The assessment phase helps us identify where problems exist in our agency’s internal process, as well as within the community we seek to make changes in. Data allow us to assess the causes and magnitude of a problem, root causes of problems, and what resources or procedures might exist to solve the problem. Through the assessment process we use both quantitative and qualitative data.

By using data and measurement, we will be able to demonstrate both small and large changes in the quality and quantity of family services due to our innovations. This means data can reveal the consequences of new policies, programs and protocols. The work we are taking on through our innovations can influence better outcomes for families in the short, intermediate and long-term future. Data tell us to what degree we are achieving meaningful and measurable outcomes.

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Lesson 2: I

OBJECTIVES

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Lesson 2: III

CHALLENGES

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Course – Lesson 2: VI. Next Steps and Assignments

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NEXT STEPS AND ASSIGNMENTS

LESSON 2:VI – ????????????

What are the lesson assignments and next steps?

Your steps may be different depending on your situation. Ideally, you are taking this course as part of a cohort — a group made up of local 100% New Mexico initiative participants. You may be the co-community organizer, action team leader or member. This is ideal, as you can discuss the course and all the information presented with people you’ll be collaborating with. However, you might be taking this course because you wish to start a 100% New Mexico initiative and today, you are a solo champion seeking to recruit stakeholders. Either way, the following steps enrich your learning experience and prepare you for Lesson 3: Plan.

Visit the Virtual Innovation Center. We provide you with links to innovations in all ten key family-serving sectors. These innovations include a menu of various projects, from across the state, nation and globe to consider implementing. The projects identified are designed to strengthen family health, safety and learning systems — and support your local 100% Community innovation.

Reviewing your course textbooks. Ideally, you have a good supply of sticky notes and sharpie pens to make comments and questions throughout Anna, Age Eight, 100% Community, and Adaptive Leadership. This makes group discussion more lively and focused as you get answers to questions and challenge assumptions.
Reading Assignment: Course participants should read “Chapter 29: Continuous Quality Improvement Guides Us with Data” in 100% Community before starting Lesson: 3. Plan.

Meet with an initiative member or work colleague to discuss the following questions.

  1. How would CQI help improve the services that our families need?
  2. Why is it important to not skip the assess and planning steps before moving to action?
  3. Why is assessing your capacity to solve a problem an important step?

Convene with fellow initiative participants to discuss this lesson and the assessment process. Ask the co-community organizers about the status of the Resilient Community Experience Survey. The data provided by the survey guide the assessment work.

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Lesson 2: V

CQI QUESTIONS

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Lesson 3: I

PLAN

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Course – Lesson 2: V. CQI Questions

CQI QUESTIONS
QUESTIONS FOR ASSESSING

LESSON 2:V – HOW DO CQI QUESTIONS GUIDE OUR PROJECT DEVELOPMENT?

UNSKIPPABLE CQI QUESTIONS

These are the questions you and your action team members will need to answer as you identify innovations and projects.

Question 1: What is the challenge you identified?

Question 2: What data did you use to identify the challenge?

Question 3: What do data tell you about the size of the challenge?

Question 4: What do data tell you about which populations are being impacted by the challenge?

Question 5: What do data tell you about the current capacity of your agency, community or county to address the challenge?

Question 6: Which data can confirm that your challenge is a priority?

Question 7: What data and/or research illustrates the root causes of the challenge?

 

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Lesson 2: VI

CAPACITY

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Lesson 2: VI

NEXT STEPS

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Course – Lesson 2: IV. Capacity

CAPACITY
WHAT CAN WE SOLVE?

LESSON 2:IV – Q+A WITH AUTHORS KATHERINE ORTEGA COURTNEY, PHD AND DOMINIC CAPPELLO

How does one assess the capacity of a community to provide basic services (health care, behavioral health care, food, shelter, transportation, job placement)?

How does one assess the capacity of a community to provide basic services (health care, behavioral health care, food, shelter, transportation, job placement)?

Dominic Cappello responds:

Dominic Cappello responds:

Our resilient community experience survey answers two vital questions: can 100% of community members access 10 vital services, and if not what are the barriers? This provides an important first step in assessing the community’s capacity to provide the 10 basic services to its residents.

One can also research the current level of services, noting how many accept Medicaid and have sliding fee scale (so no one is turned away for lack of funds). To assess the quality of the services one would need to survey community members on their experiences (satisfaction level) using the services.

How does one assess the overall capacity of a community to protect its children from ACEs, child maltreatment and trauma?

How does one assess the overall capacity of a community to protect its children from ACEs, child maltreatment and trauma?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

A community’s capacity to protect its children extends far beyond a child welfare system. Residents need to understand that child protective services is set up to respond after trauma has occurred. It is neither funded nor staffed to strengthen systems of support to keep abuse and neglect from happening in the first place. As our hypothesis demonstrates, families need access to 10 vital surviving and thriving services.

Additionally a community should have support from law enforcement, the courts and family advocates. Second, research will reveal which agencies are responsible for each of these areas and clarify if they are funded to prevent challenges, treat challenges or both. Thirdly, this requires the ability to assess and use data for planning, identify agency staffing and funding levels, assess political will and readiness to address the issues and identify community norms.

Why is it important to ask parents about their access to services?

Why is it important to ask parents about their access to services?

Dominic Cappello responds:

Dominic Cappello responds:

It is quite common to hear from agency representatives and government officials that, in general, services do exist for parents, and gaps are already understood. While this may be true in some localities, we can’t assume it’s true everywhere. Our Resilient Community Experience Survey will provide valuable data directly from those who need to access the services.

While maps and gap analyses are useful on a population level, sometimes families may not be aware of services, or know how to access them. By asking the parents and youth directly whether they are able to access services, we can not only find out whether services exist, but whether or not families are able to access them in a timely manner.

How does existing data from government departments inform the 100% community assessment process?

How does existing data from government departments inform the 100% community assessment process?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

In most localities governments do provide general information about health, safety and education. This information is useful to inform the work of 100% community. The assessment process is designed to paint a big and detailed picture of all the challenges and strengths of a community. Using existing data from government departments along with data collected through the Resilient Community Experience Survey and informational interviews can help paint this picture. 

In part two of 100% Community, the majority of the leaders represented, also represent possible sources of data.

How can the survey results lead to more questions?

How can the survey results lead to more questions?

Dominic Cappello responds:

Dominic Cappello responds:

The survey results are a catalyst for many questions from community leaders, stakeholders and the public. They provide a starting place and an opportunity to dig deeper.

For example, if parents are stating that there is no need for behavioral health care at schools, this may contradict other survey results which indicate that students are seeking such services. This is a good example of how we must always analyze data and different data sources very carefully in order to understand the context and complexities of results. Another example is that survey results may suggest that there are gaps in medical care, while agency staff representing health care point out that these services do exist. This may be pointing to a access or perception issue rather than a lack of services issue, however more digging will be necessary possibly in the form of informational interviews with both health care staff and clients in order to identify the root cause of the problem.

How will we know when we're done with the assessment phase?

How will we know when we're done with the assessment phase?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

The reality is that the assessment phase never ends. In the 100% New Mexico initiative we are always gathering data on the capacity of families to access 10 vital services. At a certain point, action teams must move on to the planning phase in order to address gaps and services. Teams will know it is time to move to the planning phase when they have identified a specific challenge through data analysis, and have a clear idea about what the root cause of that challenge might be. The CQI model also provides specific questions related to assessment that must be answered before moving on to the next phase.

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Lesson 2: III

CHALLENGES

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Lesson 2: V

CQI QUESTIONS

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