SEGMENT 7 Results Oriented Child Welfare Practice TOTAL SEGMENT TIME: 60 min
THE PARALLEL PROCESS # 39 Analytic Process for System Improvement Step 1: Initial Identification: How are we performing? Identifying performance against the standard, noting variations of performance over time and by management, unit. Clinical Casework Process Identify presenting problem Step 2: Postulating and Hypothesizing D A T A What might explain this performance? Identify potential factors influencing the outcome (who, what, where, when, why, how) I N T E R P R E T A T I O N Step 3: Testing and Findings Of these factors, what can be verified? Analyze data to verify or reject relationship Step 4: Drawing conclusions: What can we conclude from these data? Put pieces together to develop ideas of what may be contributing to performance that need to be remedied or reinforced. Conduct an Assessment Step 5: Taking Action: What can be done to improve performance? Convert interpretation into goals and plan of action. Take action steps. Case Planning Provide Services and Resources (intervention) Step 6: Monitoring Performance: Has performance improved? Monitoring outcome performance to see if actions taken are making a difference. Monitor Progress Make course corrections (Cycles back to top) Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -118-
# 40 Generalist Intervention Problem Solving Model 1 Foundation for Generalist Practice Knowledge Skills Values Engagement Assessment Planning Implementation Evaluation Termination Reassess Follow-up Discontinue Contact 1 Kirst-Ashman, K. K. & Hull, G. H. Jr. (2006). Understanding Generalist Practice (5 th ed.). Pacific Grove, CA: Brooks/Cole, Thomson Learning, Wadsworth Group. -119-
# 41 Checklist of Factors to Consider in Analysis 1 (the following is a starter list to consider) Client Factors Are any client characteristics correlated with the outcome you seek to explain? The following is a starter list to consider: Demographics (e.g. age, sex, race) County of residence Disability types Family/parent characteristics Case plan goal+ Special needs or strengths of children or family (e.g. poverty, supportive extended family, drug/alcohol usage, mental illness, parenting skills, school performance) Referral reason (e.g. abuse or neglect types) Services Factors Can the quantity or quality of services or the type of services provided help to explain the outcome being achieved? Services provided-availability and timeliness (e.g. mental health services, respite care, parent training, substance abuse treatment, or any specialized programs or treatment) Alternative/Differential Responses Interventions at first substantiation Placement type (e.g. residential, family foster care, kinship, independent living)and the agency s ability to match children with caregivers Screening process and assessment of all individuals living in foster homes Services and support available for foster parents Duration of services Conformity with policies and procedures (e.g. case plan reviews within time requirements, court recommendations approved by the supervisor) Quantity of service units (e.g. contacts with parents or child, parent-child visitation) Quality of services (e.g. engagement of family, placement proximity, licensing) 1 Checklist based on the document Strengthening child welfare supervision as a key to practice change strategy produced by the National Child Welfare Resource Center for Organizational Improvement. The authors, Paul & Graef adapted material from the following document: Moore, T.D., & Bryson, S. (2003). Results oriented management in child welfare. University of Kansas, School of Social Welfare. Terry Luna, Central RTA adapted the checklist for this T4T. -120-
Organizational Factors Is there anything the organization (agency) is doing or not doing that impacts on the achievement of this outcome? Management units (area, county, unit) Policies and procedures changes in practice, programs/initiatives, the law Staffing & Training (e.g. caseload size, turnover, vacancies, conflicts between and among staff, staff morale, timely quality training) Available resources (e.g. placement, treatment, funding) Program design the array of services provided to whom under what conditions. e.g. home based services, aftercare (reunification) services provided, concurrent case planning, separation or integration of permanency and adoption staff.) Values and culture the attitudes, beliefs and behaviors reinforced by the organization Relationship of the agency with community based organizations Budget / Funding Internal Collaboration Community Factors County of venue (judges or county/district attorneys) Child and parent attorneys Availability and cooperation of community resources (e.g. education, housing, employment, child care, mental health, medical and dental) High unemployment or economic issues in the community Stakeholder collaboration Data Accuracy Timeliness of data entry Who enters data: SW, Clerical, other staff Standard policies for data entry which screens, fields to complete Data integrity and clean up -121-
# 42 The historical journal is a timeline of activities, programs, initiatives, policies and other significant events that may have an impact on child and family outcomes. The timeline is a chronological depiction of occurrences in your county and their impact on outcomes. Some items are included to the left column. Please complete the form by adding items to both columns. INSTRUCTIONS: 1. Review the information included in the document. 2. Add items to the program, initiative, and policy implementation column 3. Add items to the impact of child and family outcomes column a. List the ways that the items in the left column could impact child and family outcomes (this is meant to be county specific) 4. Save the document and bring it to the 4/29/10 From Data to Outcomes T4T Program, Initiative, and Policy Implementation Implementation of CWS/CMS Wraparound Initiative Adoption & Safe Families act of 1997 Impact on Child and Family Outcomes Outcomes & Accountability act of 2001 (AB 636) Children & Family Services Review: Statewide Assessment -122-
Linkages Program Child & Family Service Review: On site review Performance Improvement Plan: Estimated Penalty $18,224,430 Differential Response 11 pilot county Year 1 County Self Assessment Year 1 County Self Improvement Plan Year 1 Peer Quality Case Review Year 2 County Self Assessment Year 2 County Self Improvement Plan Year 2 Peer Quality Case Review Year 3 County Self Assessment Year 3 County Self Improvement Plan Year 1 County Self Assessment Year 3 Peer Quality Case Review Year 1 County Self Improvement Plan Child & Family Service Review: On site review Year 2 County Self Assessment Year 1 Peer Quality Case Review Performance Improvement Plan: Estimated penalty $18,244,430 Year 2 County Self Improvement Plan -123-
Year 3 County Self Assessment Year 2 Peer Quality Case Review Year 3 County Self Improvement Plan Year 3 Peer Quality Case Review -124-
# 43-125- ACTIVITY: Concern Identification and Assessment Instructions: 1. Refer to the National Standards Activity handout that you completed earlier 2. Using the Checklist of Factors form conduct an assessment to analyze individual factors that may be impacting the outcome measures you identified Outcome Measure or Composite Identified: STRENGTHS.. MY COUNTY DID WELL BECAUSE: NEEDS / CONCERNS MY COUNTY DID NOT DO WELL BECAUSE: CLIENT FACTORS: CLIENT FACTORS: SERVICES FACTORS: SERVICES FACTORS: ORGANIZATIONAL FACTORS: ORGANIZATIONAL FACTORS:
-126- STRENGTHS.. MY COUNTY DID WELL BECAUSE: NEEDS / CONCERNS MY COUNTY DID NOT DO WELL BECAUSE: COMMUNITY FACTORS: COMMUNITY FACTORS: DATA ACCURACY FACTORS: DATA ACCURACY FACTORS: OTHER FACTORS: OTHER FACTORS:
# 45 Seven Steps to a Results Oriented Culture Take Responsibility Use Data Routinely Lead Improvement Efforts Results Oriented Culture Stimulate Positive Action Encourage Learning Reward & Recognize Seek Involvement Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -127-
# 46 Use Data Routinely Trainer Talking Points The first and perhaps most important thing a manager can do is to share performance reports on a regular basis. In a culture where blaming and punishing is the norm, staff are at best leery about performance data and at worst, hostile to performance reports. It is challenging to create a safe environment in which performance data can be seen as a tool for improving services and outcomes for clients. Here are a few ideas for initiating the productive use of data. Start slow When first introducing data to your staff, you may want to start out slowly. Be non- judgmental Take a non-judgmental approach to reviewing the data. No one gets beat up, humiliated, or put on the spot. Throw a Data Party Yes, a data party. When first introducing performance data, a fun, non-threatening environment may be just what is needed. Establish a routine The regularity of seeing reports makes them less threatening over time. Not disclose individuals performance - Do not share performance of individual front line workers with others. Team performance is okay to share, but individual performance can be shared privately. Remember, the numbers are often so very small when looking at outcomes, that it can be misleading to look at individual performance anyway. Take responsibility for results - Taking responsibility for good performance is easy (we will talk about rewarding later). Taking responsibility for unsatisfactory or below standard performance presents more of a challenge. o Taking responsibility leads to: Empowerment Energy Creativity Challenge Competence It is common to identify and discuss possible causes of poor performance. The important thing is to accept responsibility for doing something about it. Consider the following actions: Explore results-based data in non-blaming ways. To move beyond the identification of causes, you can: o Get more specific about the cause. Instead of identifying the Judge s personality as the problem, identify the Judge s great reluctance to Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -128-
terminate parental rights. In this case a behavior is easier to change than a personality. o Broaden your scope of identified factors that may contribute to poor performance. Rarely is it due to just one factor. o Do not allow the discussion or exploration stop with the identification of a cause. Approach the process with the idea that there is always something that can be done, even if it is small. Keep the focus on what you can do Ask what is within your control to change or influence (however slightly). o If the identified cause is not within your direct control to change (few things are) ask how you can influence it. o If there are a number of strategies from which to choose, choose the ones that are the most within your control or -sphere of influence. o Re-frame the problem Challenge staff without criticizing. Approach poor performance from the perspective of what can be done to improve performance in the future rather than dwelling on the past. Stimulate positive action It is important to do something even if it is to gather data and study it further. After the phase we discussed above for establishing a safe environment, it is important to take positive action toward improving program performance. Understand the performance problem While the message is to do something, it is not to do any old thing. Set goals and decide on action to take This is covered well in Module 11, Taking Action for Program Improvement. Follow-through with plans Why develop a plan of action unless you follow through? Without follow-through, staff and other stakeholders will be less likely to want to spend their time planning the next time you need to address a performance problem. Dare to think big Why not try to change a state policy or seek new resources for your community? We have often seen field managers not exploring many action options because of barriers that are perceived as beyond their influence. Examples include: state procedures or policy, the lack of available resources, a judge or district attorney, or unavailable or uncooperative community resources. o Document the barrier you are experiencing in achieving outcomes. o Write letters or memos to the highest level you can (without getting yourself in trouble). o Invite those you want to influence to your office or go talk to them to discuss the problem you are experiencing and the solutions you see. o Ask for technical assistance. Innovate and be creative When developing action plans, have a little fun get outlandish. It sometimes helps you to uncover innovative solutions. A suggestion Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -129-
to bribe the judge with a bottle of scotch can easily turn into giving the judge more frequent reports (or something else he may want). Above all, do something By taking positive action to improve performance you are conveying to your staff that you see yourself and your team as influential. Reward and reinforce We all know the power of recognizing people for doing good work. The problem is that we often do not take the time to do it. Rewards, however small, reinforce those actions, behaviors and values that you, as a manager, seek to encourage. In a rewards-based environment: People feel like winners. People s need to achieve is met. Staff have ample cues that define good work. Everyone shares in the success of others. Everyone participates in providing rewards. The focus is on good practice and outcomes more than problems. A fun atmosphere is created where people enjoy their work. Here are a few tips on establishing a rewards-based environment: 1. Use a variety of rewards - There are unlimited kinds of rewards that you can give, and you do not have to spend money. 2. Provide valued rewards The reward should be something that the recipient values or wants. 3. Provide frequent and varied rewards Rewards should be an everyday occurrence; however, it is neither possible nor effective to reward a behavior every time it occurs. Actually, rewards are most effective if they are provided on an unpredictable or variable schedule. Think of the power of intermittent rewards involved in gambling. 4. Celebrate good performance - There is almost always good news in the data for your team performance. 5. Reward the little things, even effort Since big things do not happen as often, it is important to recognize the little things. 6. Specify reasons for rewards The most effective rewards are ones that are specific. 7. Provide timely reward The closer the timing of the reward is to whatever you are rewarding, the better it is. 8. Encourage reward giving To establish a rewards-based environment you are both a giver of rewards and an instigator of people rewarding each other. 9. Be thoughtful While not specifically a reward, doing something thoughtful on a personal level goes a long ways towards recognizing the worth of people you work with. Seek involvement of others. Although you can take action alone, involving others in efforts to improve outcome performance has several advantages: Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -130-
1. Enriched understanding of the performance problem due to the input from multiple perspectives, 2. More ideas for how to improve performance, 3. Increased focus on outcomes you are striving to achieve, and 4. Greater ownership and cooperation for carrying out the action plan. This often involves meetings but does not have to. Here are some tips if using task oriented groups: Respect the time of others Involve key people Have someone in charge. Encourage learning and sharing knowledge Many of the leading management gurus talk about the importance of establishing a learning culture. Peter Senge, describes a learning organization as follows: where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free and where people are continually learning how to learn together. Peter Senge, The Fifth Discipline The most effective agencies are those that are engaged in learning and continuous improvement. They are curious about their performance, how they can improve, what has worked and what has not, and what others have found effective. Here are a few ideas to promote learning: Learn from those who are doing well Review successes and Consult professional literature and web resources Provide ongoing training Arrange mentoring Seek input from consumers Provide opportunities for staff to share their knowledge Lead improvement efforts Building a results-oriented organizational culture requires that you talk the talk and walk the walk both of which provides staff with guidance and direction. Do as you say Be optimistic Establish your unit s identity Follow-through on plans Stay the course Curb your own cynicism The Elusive Culture Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -131-
Without a doubt, organizational cultures are difficult to recognize for those indoctrinated in the culture. The culture of your management unit is difficult to recognize since you are part of its culture. You both shape the culture and are shaped by the culture in ways you probably do not realize. There are a couple things you can do to become more aware of the culture of the unit you manage: Ask others what they notice about your unit (e.g. attitudes). Visit other units (e.g. participate in meetings). Take some time to be an uninvolved observer and just try to look at things from a detached perspective. You can make a difference Believe if or not, your staff pays attention to what you say, what you do and what you believe. You can have a substantial influence in making the culture in your unit what you want it to be. In this module we have outlined how you can go about achieving that. What we have not said is that you may have to give up some old habits. Blaming may be one of the more difficult. Believe in yourself and in the ability for positive change to occur. Curb your negative banter and vent elsewhere. It is easy over time to give up believing that there are solutions (or at least partial solutions) to the problems that plague your unit s performance. It may be time to re-test your assumptions and give it another shot. Be persistent. You may not be a numbers person, but let these outcome data give you some clues about how to move your group forward. Learn about how the measures are figured. Start to ask questions about your unit s performance and see if there is data that can inform you. Let your cynicism go. It is easy to get cynical over time and begin to believe that there is no use in trying. Results Oriented Management in Child Welfare. http://www.rom.ku.edu/ -132-