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Course – Lesson 7: III. Improve – CQI DRIVES US

IMPROVE
CQI DRIVES US

LESSON 7:III – HOW CQI DRIVES THE INITIATIVE AND EACH PROJECT

Revisiting CQI

Our entire 100% New Mexico initiative should work like a successful enterprise, with the most highly rated service in the county. By service, we mean that when elected leaders, stakeholders and the public hear of the projects being implemented to improve services, we hope the reaction is, “These people know how to make things happen.” For this reason, we are revisiting continuous quality improvement (CQI) so there’s no confusion about what we do and how we do it. While we love convening and discussing problems as much as anyone, this initiative creates ten action teams who spend their time turning data into action that’s measurable and meaningful to every family in the county.

As we have discussed throughout the course, CQI is the ongoing process of identifying, describing, and analyzing strengths and problems and then testing, implementing, learning from, and revising solutions.

CQI is an ongoing effort to improve products, services, or processes. These efforts can seek small or incremental improvement over time or, in some cases, lead to a huge “breakthrough” improvement all at once. All aspects of an organization’s processes, including co-workers collaboration and serving clients, are constantly evaluated and improved in the light of their user-friendliness, efficiency and flexibility. Within the public sectors, CQI is seen as a tool used to provide changes that are both measurable and meaningful to the public.

Many people have contributed to the field of quality improvement, notably Edward Deming who is best known for his work in Japan with the leaders of Japanese automobile industry in the 1950s.

There are a number of key actions of the CQI Process. The following seven are those we find especially important:

  1. Identify an issue using data or some other reliable source of information.
  2. Research ideas around the reasoning behind that issue and the current level of performance.
  3. Set a time-bound, measurable goal the team wishes to achieve after reviewing the issue.
  4. Develop action steps to address the issue.
  5. Action steps should include the person/people responsible and the target date for completion of the action step.
  6. Track and adjust the action steps to determine if planned interventions are working.
  7. Close the feedback loop by sharing the information learned with others.

CQI is our most favored model for quality improvement when working in the public sector with the goal of getting to results. Many people have invented various forms of quality improvement but if you scratch the service of most of them, you will see that improving a system or solving challenges comes down to four skills: assessing, planning, acting and evaluating.

CQI is the framework that will be guiding all action teams in the 100% Community Initiative. Every stakeholder involved in a particular sector should have at least a basic understanding of the CQI framework. With some projects the problem identified may be a lack of quality on the part of a particular agency. If this is the case, the action teams may propose to the agency leadership that CQI may be used to address agency’s challenges. Action teams may discover in the assessment process that it’s not the quality (or lack of quality) of an organization that’s the problem, instead it may be that there is not an organization to provide the service.

The key components of the CQI cycle that we use are assess, plan, act and evaluate.

Assess: Using data, a change agent or action team will identify the magnitude of a challenge, the capacity of local organizations to address a challenge.

Plan: After analyzing data, a change agent of action team will build a measurable plan. We recommend using a planning tool called a logic model that identifies the goal, inputs/partners needed, activities and measurable outcomes.

Act: Implement plan, working with strategic partnerships, with measurable short term, intermediate and long-term outcomes.

Evaluate: Monitor progress with all stakeholders.

Each of these four components, or phases, comes with a set of questions to ensure that the change agent or action team is using data to support the improvement process every step of the way.

CQI is a Team Process

CQI cannot operate in a vacuum. Objectives, goals, and implementation are shared responsibilities and activities. When the team shares an understanding of the process, the team can move forward as one. When an action team works together, CQI is fully supported.

Quality Data and the CQI process

We need quality data that is accurate and timely in order to assess a challenge. Data need to be current and analyzed with care to support the entire CQI process. Our action teams focused on the surviving and thriving services will be in contact with a wide variety of agencies providing specific services. Data will need to guide all attempts at improvement.

Who Wants CQI and Who Doesn’t

State and local stakeholders, including elected leaders, have a wide range of reactions to both CQI and a data-driven process. Data, used correctly, will show where systems aren’t working or don’t exist where they should. Many want this information in the fields of health, safety, education and economic development–and across the public sector. There are also those who prefer to use hunches or opinions to guide work, rather than data.

POSITIVE RESPONSES

  • Opens up all aspects of work to possible improvement.
  • Frees up ways of thinking about work (we’ve never done it that way before).
  • Reframes the idea of failure. Turns it into an experiment.
  • Makes it a process of discovery and adaptation.
  • Allows for growth and encourages growth.
  • Helps to keep priorities upfront.
  • Can change the culture of the office/organization.
  • Improves organizational accountability.
  • Refines service delivery process.
  • Supports flexibility when meeting service needs change.
  • Enhances information management, client tracking & documentation.
  • Lends itself to design of new programs & program components.
  • Allows creative/innovative solutions.

NEGATIVE REACTIONS OR DISRUPTIVE RESPONSES

  • People may feel threatened by CQI and use of data to assess their work, leading to fears of being judged
  • People feel a sense of loss as the old way of making decisions (by hunch, or idea of a higher up) is traded in for a data-driven process.
  • It spotlights processes, services or products that aren’t working, and this may shine light on ineffective investments and investors.
  • It may show how certain populations are experiencing social adversity, injustices and health, education and opportunity disparities.

We provide more information about the CQI process in Appendix G, including sample answers to all the CQI questions focused on assessing, planning, acting and evaluating. We use the example of an action team considering the development of a school-based behavioral health center to illustrate how CQI works.

CQI: questions for each phase with sample answers

The following Q+A is designed to provide 100% Community course participants and action team members with a sample of how to answer the key continuous quality improvement questions (CQI) related to developing a local innovation. In this example, an action team has reviewed the 100% Community survey data and seen that many parents report having a lack of access to behavioral health care in general, along with their children not having access to it at school.

Q+A: Assessment

Question: What is the challenge you identified?
Example: Our students at our middle school face emotional challenges due in part to adverse childhood experiences. Students at our school use alcohol and recreational drugs at early ages, as well as consider suicide.

Question: What data did you use to identify the challenge?
Example: In addition to the countywide 100% Community survey results where 46% of parents reported challenges to accessing behavioral health care in the community or at school, the Youth Risk and Behavior Survey (YRBS), specifically the data around initiation of alcohol use by age 12 and rates of suicidal thoughts by both middle and high school students. Data from the 2009 Public Health Survey of Adults that asked questions about ACEs. Data from the article, “The Prevalence of Confirmed Maltreatment Among US Children, 2004 to 2011” in JAMA (2014) by Wildman, Emanuel and Leventhal, concluded that maltreatment will be confirmed for 1 in 8 US children by 18 years of age. The authors reported that this was far greater than the 1 in 100 children whose maltreatment has been confirmed annually by child welfare systems across the nation. For black children, the cumulative prevalence is 1 in 5; for Native American children, 1 in 7.

Question: What do data tell you about the size of the challenge?
Example: According to the most recent Youth Risk Behavior Survey (YRBS), 1 out of 5 middle school students report suicidal thoughts. Slightly less for HS students in the county. Many students at our middle school did not take the YRBS, therefore the need may be greater than we thought.

Question: What do data tell you about which populations are being impacted by the challenge?
Example: Data from the article, “The Prevalence of Confirmed Maltreatment Among US Children, 2004 to 2011” in JAMA 2014 by Wildman, Emanuel, and Leventhal that concluded that maltreatment will be confirmed for 1 in 5 black children, and 1 in 7 Native American children. 1 in 5 children live in households where the income is below the federal poverty income. Our middle school is located in a zip code that has a mix of incomes and many students with different ethnicities, with a significant proportion being Hispanic.

Question: What do data tell you about the current capacity of your agency, community or county to address the challenge?
Example: The rates of underage substance use and suicide ideation have not changed significantly for many years indicating a lack of community capacity to address the challenge. Our school does not have staff to address substance use with our middle schoolers nor their parents. There is limited funding for our school to increase behavioral health services for our students.

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

Binge drinking rates, from the YRBS, among MS and HS students indicate a challenge.

Rates of suicidal thoughts are present in middle school and continue to high school (from the Youth Risk Behavior Survey). Depression among adults and ACEs scores from the latest Behavioral Risk Factor Surveillance System (BRFSS) public health survey of adults.

Question: What data and/or research illustrates the root causes of the challenge?
Example: We are exploring root causes of suicidal thoughts by looking at academic literature and books on suicidal thoughts. There can be a host of reasons — including Adverse Childhood Experiences. Past research on ACEs shows that there is a link between adult behavioral health outcomes and early childhood experiences. In our state 60% of adults report having at least one ACEs according our state Public Health Adult Survey. In small samples, as many as three-quarters of high school students report having 3 or more ACEs. Some with 7 to 10 ACEs.

Q+A: Planning Phase

Question: Which component of the challenge will you address with a local project?
Example: There were many issues we identified (substance use, depression, ACEs and suicidal thoughts). We wish to focus on addressing depression in students, as well as adverse childhood experiences. We want to explore evidence-informed prevention processes.

Question: Describe your review of research focused on your challenge?
Example: More ACE research to come:

CDC’s Adverse Childhood Experiences (ACEs) Information: https://aae.how/219
Category Archives: Adverse childhood experiences: https://aae.how/220
Robert Wood Johnson Foundation on Adverse Childhood Experiences: https://aae.how/221
Youth Risk Behavior Surveillance System (Depression in Youth): https://aae.how/222

Question: What potential evidence-informed solutions exist in the research?
Example: Because ACEs represent a number of challenges (child abuse, neglect, growing up in households with violence or substance abuse, or with adults with mental health challenges, etc.), we want to first focus on identifying the challenges/ACEs endured by our middle school students. We understand that our students and their parents may have untreated trauma due to ACEs. In some households ACEs continue. We seek, at first, to be able to offer to students and their family members behavioral health care that is easily accessible and culturally appropriate.

We reviewed research on current evidence-informed solutions for ACEs. There are many challenges and approaches to addressing child abuse, neglect, growing up in households with violence or substance abuse, etc. We understand that families have many needs such as stable housing, secure food and access to medical care and transportation. We have been reviewing the literature on community schools which have funding for school-based behavioral health care among many other services. We are prioritizing school-based behavioral health care.

Since we mainly have influence at our middle school, we want to focus on first identifying/ACEs endured by our middle school students and helping our students and their families access behavioral health care. One approach we found is called Screening, Brief Intervention and Referral to Treatment (https://aae.how/223). We are still reviewing many forms of support that could be made available if our school had a behavioral health care center.

Question: What is the hypothesis that illustrates how your actions might solve the challenge? (As in, “if you do A, then B will happen.”)
Example: If we can increase our capacity to provide behavioral health care at our school, we can implement ACEs screening. With a team of school-based behavioral health care providers, we can help students and their families to get quality, culturally appropriate and easily accessible behavioral health. Behavioral health treatment can lead to a reduction in early substance misuse, depression and suicidal thoughts. We can help parents to address their problematic behaviors so that ACEs end in their household.

Question: What are your key steps, timelines, roles and responsibilities related to your project?
Example: Our course project requires creating awareness of the epidemic levels of ACEs and the relationship between ACEs and early substance misuse, depression and suicidal thoughts. This awareness is a short-term outcome.

Intermediate-term, we are looking into creating funding for more behavioral health care staff at the school.

Long-term, we want to fund the creation of a school-based health/wellness center with the capacity to offer behavioral health care to both students and their family members. This is a long-term project requiring, increased funding, and buy in from stakeholders on the school, district, city and county levels. We may also need support from state government and health care institutions.

Question: What unintended consequences might you encounter?
Example: Other school-based health centers we have looked at have had different reactions. Some have been very welcomed by the entire school community. Others have had backlash from parents who do not approve of behavioral health care or school-based health centers for fear that “personal family issues” may be revealed or that health centers may provide unwelcome health advice to youth.

We also may find that there are not enough appropriate referrals in our community to help families access vital services once we do identify problems related to ACEs.

Some behavioral health care agencies are limited to which services they can provide.

Q+A: Action Phase

Question: How will you secure buy in for the course project (innovation or change initiative) in your workplace and/or community?
Example: We will start with qualitative data. We hope to do informational interviews with local school management, school board members, parents, students, city hall, county government and the local hospital and behavioral health care providers. We will use their input to get buy-in. We need to build support among potential funders. We can then seek to gather data on the magnitude of ACEs, along with substance misuse and suicidal ideation, within our student and parent populations.

Question: Which, of all your proposed activities, are the most vital?
Example: Buy-in from school principal and school board for phase one: creating awareness of the challenges and potential solutions. We also need ongoing awareness of ACEs from our school staff and parents. For our long-term goals, we will need establishing funding to be one of our most vital activities. For all of our efforts, we will need data (qualitative and quantitative) as a vital component to educate and ensure buy-in along the way.

Question: How will you begin implementation of the course project?
Example: We will start by contacting the state Department of Health (DOH), Office of School and Adolescent Health and the state coalition for school-based health to learn the latest policies on school-based health centers. We will also explore how some school-based health centers were funded. We have identified fully-resourced community schools in the state and schools with fully-funded behavioral health care centers. From there we begin our process of information gathering through interviews with stakeholders.

Question: How will you record and monitor activities as your course project unfolds?
Example: All information interviews with stakeholders will be recorded, documented and filed on Google docs. We will also do surveys — via Google forms and record findings.

Question: What will your process be for making adjustments to your course project?
Example: We will meet monthly to assess progress. We will consider adjustments using the data we are collecting along the way as part of our process.

Question: How will you ensure data is collected along the way as your course project unfolds?
Example: We will have a monthly report at our meeting on all findings (qualitative and quantitative data, research articles on our topic areas) — and create a quarterly update sent out to all participants and stakeholders.

Q+A: Evaluation Phase

Question: How will you analyze and share all relevant data with those working on the experiment?
Example: Analyses will require our team working with a data specialist. We have identified one at our local college. We will create a database that all our members can access and a project management system called Freedcamp, to share all documents.

Question: How will you ensure that your data and evaluation are presented in an easy to understand manner?
Example: We will have a data expert on our team and run all data by a data committee. We will ask for support from the Office of School Health-DOH — in reviewing data. We will use data visualization (for example Tableau software) to help increase awareness.

Question: How will you determine the strengths and weaknesses of the course project?
Example: Strengths will be assessed by the aspects of the project that are going well and moving forward with support from stakeholders. Weaknesses will be identified by areas that have limited ability to make movement forward on our project.

Question: How will you determine the impact of the course project on your challenge?
Example: The overall impact for the project is long-term. Our initial phase is awareness which will be determined by follow-up surveys. Our intermediate phase will be determined by assessing the amount of funding we have been able to secure and number of providers we have been able to hire. Long-term outcomes can be monitored over the years. We can use measures from the YRBS on substance use, depression and suicidal thoughts, the number of ACEs screens we are able to complete at our middle school per year, and the number of students and families that are receiving services due to school ACEs screening.

Question: How will you identify the unintended consequences?
Example: We need to set up a process to track the parent’s reactions to school-based behavioral health. Surveys and informational interviews can be valuable tools to identify the unintended consequences.

Question: How will you measure if people (employees and/or residents impacted by the course project) are better off?
Example: We will use surveys and existing data to assess:

Short term: The amount of constructive dialogue between school staff, parents, students and district personal on the topic of ACEs and the need to address it

The percentage of awareness of school staff, parents and students of the local rates of ACEs, depression and substance misuse and potential evidence-based solutions

Usage of local behavioral health agencies by parents and youth

Usage of the counseling staff by students and family members

Amount of funding for school and community support for school-based behavioral health including financial support

Long term: significant changes in access to behavioral health care for our students and their family members, we should see a decrease in problems associated with youth depression, substance use and suicidal thoughts — as indicated by Youth Risk and Behavior Survey

Question: How will you ensure that you communicate with all stakeholders on the results of the experiment?
Example: We will use the internet and social networking tools to share our progress and successes — as well as challenges. We will make sure our monthly meetings include time to plan communication with stakeholders who are not able to attend meetings.

Finding answers

As you can see from this example of CQI question and answers, local community stakeholders can create a very informative and thoughtful strategic plan to take on a project. Please let the 100% Community course instructors or coaches know if you need assistance answering any question as you develop your project plan. We look forward to supporting the development of your course project/innovation. Make sure to review the course website’s links to research articles and other resources.

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Lesson 7:II

CONCEPTS

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Lesson 7:IV

IMPACT

Related Posts

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Course – Lesson 7: VIII. What are lesson assignments and next steps?

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NEXT STEPS AND ASSIGNMENTS

LESSON 7:VIII – What are lesson assignments and next steps?

Step by Step

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 to begin developing your innovations and projects. 

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: By now, you should at least be well into Anna, Age Eight, 100% Community and Adaptive Leadership. Collectively, these texts provide you with a solid understanding of our 20 key concepts. All three books could serve as reference guides for not only 100% Community Initiative participants, but for all stakeholders in your county. 

You may find that Anna, Age Eight serves as an excellent call to action, and you may wish to share this book widely in your community. You can build entire forums, book clubs,  and workshops around Anna’s story. 

100% Community is your step by step guide that you’ll find you don’t want to be far from (we sure aren’t). The chapter that focuses on your sector should be made widely available to everyone working in your sector throughout your county. 

Lastly, Adaptive Leadership is a book you will want to reference once you start going out into the field and meeting with leaders and stakeholders. When you get your first “we’re already doing this” or “you’re not acknowledging the work we’ve already done”, you will want to really understand the fundamentals of an adaptive challenge.

READY TO REVISIT READINESS?

Lesson 7

Congratulations, you’ve just completed the 100% Community Course. This means you are one of the first people in the nation to have successfully participated in a learning experience focused on the data-driven prevention of ACES, trauma and social adversity. Kudos to you.

When you started the course, you took the Readiness survey. Are you ready to take it one more time to assess your knowledge? If you hit any challenging questions, you find the chapters they are answered in noted along with the question. We acknowledge that our twenty key concepts represent many fields of study. For this reason, we are never far from our copy of 100% Community to refresh our memories.

You are just beginning a groundbreaking initiative that could potentially transform your community. You are also now part of a national network of champions who share your knowledge, drive and passion. Reach out to us so that we can assist you in connecting to all the 100% Community Initiative projects. We also offer our blog 10@100% where you can read and submit insightful articles. Welcome to our team and movement to ensure safe childhoods for all.

author photo

Katherine and Dom

Katherine Ortega Courtney, PhD and Dominic Cappello
Coauthors of Anna, Age Eight and 100% Community

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Lesson 7:VII

QUESTIONS

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Innovations

10 AREAS AWAIT US

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Course – Lesson 7: VII. Questions

QUESTIONS
ARE YOU READY?

LESSON 7:VII – VITAL QUESTIONS TO CONSIDER

Real World Work

In 100% Community “PART THREE: Countdown to 100%,” we ask the following questions at the end. It can only strengthen your initiative by asking and answering these questions with initiative participants before proceeding with real-world work on the 100% New Mexico initiative.

Really, you’ll thank us later.

  1. In chapter 29, we wrote about the importance of data, not opinions, guiding our work in a process of continuous quality improvement. First, what’s been your experience using data to guide projects? Second, why is Continuous Quality Improvement a data-driven process?
  2. In chapter 30, we suggested, based on reading The Practice of Adaptive Leadership, that people fear loss, not change. Can you think of a time when loss aversion has either obstructed or supported change in your communities?
  3. In chapter 31, we promoted the collective impact model to guide our work. How might we support organizations and our action team members in using the Collective Impact model to best achieve results?
  4. In chapter 32, we laid out the 100% New Mexico initiative in 10 steps. First, which of those steps may be the most challenging, and why? Second, which individuals or organizations in your county can fill the roles we describe?
  5. In chapter 33, we advocated for a 100% Community Task Force on Historical Trauma. Why is it important for all of your county residents to learn about historical trauma and historical resilience?
  6. In chapter 34, we described potential timelines for various components of the initiative. How realistic are they given the capacity of your county?
  7. In chapter 35, we focused on life-long learning as a key component of our initiative. Who are partners in your county or state who could support this goal?
  8. In chapter 36, we offered some insights on using technology to strengthen your community work. In your experience, how is tech and the web used to promote health, safety and education in your county — and with what results?
  9. In chapter 37, we described how the public sector workforces (representing hundreds of organizations) work primarily in silos, not in collaboration. How can your county remedy that using technology and relationship-building?
  10. In chapter 38, we focused on place for synergy in order to develop strategies for healing disrupted economies. How can private sector partners in your county work with public sector change agents to bring about solutions?
  11. In chapter 39, we arrive at a place called “Faith.” Here we focus on the role of faith in the compassion of others to serve all our children and families. How can your partners in your county pursue a dialogue with all your faith-based communities, all who hold a value that all people matter, especially the most vulnerable among us, to support the work ahead?

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Lesson 7:VI

10 STEPS

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Lesson 7:VIII

NEXT STEPS

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Course – Lesson 7: VI. 10 Steps – Getting To 10@100%

10 STEPS
GETTING TO 10@100%

LESSON 7:VI – Q+A WITH AUTHORS KATHERINE ORTEGA COURTNEY, PHD AND DOMINIC CAPPELLO

How is the backbone of the initiative created?

How is the backbone of the initiative created?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

Step 1 is called Creating the Backbone. 100% Community developers meet with a core team of local champions who wish to explore bringing the 100% New Mexico initiative to their county. These might be two people who have read 100% Community and are synch with our vision, goals and activities. We work with this local team, called our 100% community organizers, using the collective impact model that promotes the following five features:

  1. A common vision and agenda
  2. Collaboration and mutually-reinforcing activities
  3. Continuous communication and transparency
  4. Shared measurement and use of data
  5. Backbone support in the form of a local agency

It’s here you’ll find insights in “Chapter 31: Sharing the Vision to Achieve Collective Impact.” We can also share with you how localities are finding agency partners and economic bases for the work.

Each county starts their initiative in a different way. Some start with a book club focused on discussing Anna, Age Eight or 100% Community. Others dive right into community convenings while others set up a monthly networking and professional development gathering to build a strong sense of community. The roles of the first champions to start the work included a rural health clinic medical director, a city councilor, a college president, a school board member, a university physics professor, and a socially-engaged grandmother/public servant/former congressional aide.

What are the activities to engage county residents?

What are the activities to engage county residents?

Dominic Cappello responds:

Dominic Cappello responds:

We move to Step 2: Sponsoring Community Forums. We support the community organizers in sponsoring community forums across the county to gather feedback from those working in our 10 “surviving” and “thriving” sectors, which includes higher education and socially-engaged youth and adults. We promote the reading of Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment and 100% Community: Ensuring trauma-free and thriving children, students and families.

Through a series of forums and events, the local community organizers listen carefully to all comments, concerns, suggestions and ideas, creating a report that details the wide range of perspectives on ACEs prevention and treatment, as well identifying who is already doing vital work to support county residents. The more dialogue that can take place across the county, the more informed the community organizers will be about the change that the 100% Community program may represent. To many, change can mean loss or disruption in the status quo, and any successful initiative like ours must acknowledge community members’ feelings with respect and patience.

We have seen very positive results by hosting what Dona Ana County, New Mexico calls “Great Conversations.” Ask us about these community gathering where one question is posed to a group of community residents and insights are shared in a structures and respectful process.

How are leaders from ten diverse sectors recruited?

How are leaders from ten diverse sectors recruited?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

Welcome to Step 3: Convening Leaders in 10 Sectors. Community organizers convene a series of meetings of agency leaders from all 10 “surviving” and “thriving” sectors to assess their interest in the 100% New Mexico initiative and their capacity to devote time to it. Eventually, the plan is that they will commit to leading or joining an action team (with the goal of developing their in-agency projects or collective projects). The goal of the action teams is to strengthen services so that 100% of residents have access to them in a timely manner. 100% Community action teams are comprised of members who commit to weekly work, and completing the 100% Community course.

Ask us about what we call “The San Miguel County Model” and their approach to recruiting potential action team members by starting a book club with the 100% Community chapters as their focus. To get a good overview on the ten sectors, read all of Part Four: Workbook for Action Teams that contains the ten chapters on the ten surviving and thriving service areas.

When do we survey our parents and youth to identify gaps in services?

When do we survey our parents and youth to identify gaps in services?

Dominic Cappello responds:

Dominic Cappello responds:

This is where we really engage with the community. Step 4: Conduct the 100% Community Survey is where we ask, “How easy is it to access vital services?”

This county-wide survey assesses to what degree local parents and youth have access to the 10 key “surviving” and “thriving” service areas/programs. This data will identify gaps in services in specific areas of the county and why there are challenges accessing services. This survey data provides the 100% New Mexico initiative with focus areas in all cities, towns and communities within county borders for innovations and projects. As the survey process unfolds, the community organizers and action teams leaders can identify all the current work being done in all ten sectors, including task forces, committees and research groups.

The survey process has been used in a variety of counties and communities. Ask us about recruiting survey takers, identifying communities to focus on, and best places to connect with parents and youth.

When do we report on the survey results?

When do we report on the survey results?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

This brings us what should be an important event for the iniativate and elected leaders and stakeholders. We enter Step 5: Sponsor a 100% Community Town Hall to Share Survey Results. Community organizers, along with action team leaders, invite all county leaders, stakeholders and the public to an event where they share the findings of the survey, detailing where gaps in services exist and why residents reported they had challenges accessing services. Leaders from all 10 “surviving” and “thriving” sectors share the current work to address gaps and offer opportunities for residents to work in alignment with the efforts of city and county government, along with school boards, nonprofit agencies, child welfare, higher education and the business sector.

A review of chapter 23 on Foundations might give you the insights to approach a foundation for support of summits, town hall or forums. Or plan B is partnering with higher education who will have meeting rooms and technology. chapter 22 gives insights into partnerships with colleges and universities.

The summit provides an opportunity to engage stakeholders in becoming action team leaders. The summit is really a starting point to beginning the real work of the initiative- closing gaps identified through the survey.

How are participants for the 100% Course identified and recruited?

How are participants for the 100% Course identified and recruited?

Dominic Cappello responds:

Dominic Cappello responds:

Well, in some ways you know as you are in this course. We hear from counties that every recruitment process is different. So we have Step 6: Recruit for and launch the 100% Community Course.

The community organizers and action team members take the 100% Community course, which includes classroom instruction, coaching and web-based lessons that are customized to meet local needs. Lessons include:

  1. Engaging with the community
  2. Assess the challenge
  3. Plan with research and logic
  4. Act with partnerships
  5. Evaluating Progress
  6. Partner and build strategic relationships
  7. Program for results

This 100% Community course prepares the 100% New Mexico initiative leaders of the 10 action teams to work in a data-driven process of continuous quality improvement (CQI) focused on four phases: assessment, planning, action and evaluation. The course textbook 100% Community provides to all action team members evidence-informed innovations and projects to consider implementing. The goal is to get all 10 sectors serving 100% of county residents.

Courses can be customized to meet the needs of local participants and you can also look into CEUs. You will also wish to read “Appendix H: Evaluation begins with Questions” so that when leaders or funders ask, “How are you evaluating all this?” you have an answer.

As you recruit you will find people wanting to focus on trauma-informed activities, which means a focus on public awareness or improving communication skills or mindfulness. While this is all important in the long run, the priority first is ensuring that all residents have access to the survival services that keep them healthy and safe. You will have to, repeatedly, remind people of the priorities based on our understanding of the needs of our most vulnerable residents.

Can you tell us how planning is done in various localities?

Can you tell us how planning is done in various localities?

Katherine Ortega Courtney, PhD responds:

Katherine Ortega Courtney, PhD responds:

Yes, we are talking about Step 7: Planning.

Once our action teams have the survey data and have been through the 100% community training, they are ready for the planning stage. Teams will review the research for each sector, much of which is outlined in 100% Community and on our website called the 100% Innovation Center. Teams will then consider possible funding sources and develop a detailed action plan, including who is responsible for what and when each step of CQI can be expected to be completed. We will also develop a logic model, a planning tool detailing all aspects of a particular project, so that everyone working within the 100% New Mexico initiative can see how the plans will lead to the desired outcomes. Each innovation and project will require a logic model to guide the action teams.

Here you will want to review “Chapter 29: Continuous Quality Improvement Guides Us with Data” and explore the toolbox (aka the Appendices) which houses a logic model, org chart, partnership chart, timeline and more insights into using the continuous quality improvement framework.

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