The Texas Child and Family Services Review Team has approached their quality assurance process in four distinct ways, and are incorporating these tools into the social work practice of the State of Texas. Their CFSR Program Improvement Plan (PIP) was approved in April of 2003, but these efforts were well under way before that.
Overview
In 1987-88, efforts were made to focus on the importance of quality assurance in the Child Welfare program throughout Texas. An Operational Audit and Planning Process (OAPP) was developed at this time to review and evaluate critical components, such as administration and management operations, issues of compliance to state and federal law and regulations, community relations, and staff/client satisfaction, to name a few. Over time, this process evolved into the current CPS Quality Assurance System, which incorporates the current practices utilized by the Texas Child and Family Services Review Team.
The team is using a variety of methods to delve deeper into their data, measuring the relevant indicators for the CFSR. They strive to look closely at the data that exists and find ways to slice that data into sections that make inquiry more useful, meaningful, and measurable. The benefits of such investigation are possible modifications and enhancements in the policy and practice of Child Protective Services in the State of Texas. They are a team of 4, with one lead and 3 generalists, with varying backgrounds in data and/or fieldwork.
Here is a brief description of the pieces of the “Texas Toolkit.”
1) Regional Reviews
They plan to perform periodic reviews at the regional level, to tackle smaller slices of the population, and take the social workers and their supervisors through the process of the CFSR. This serves the dual purpose of educating their staff as to expectations and requirements, and allows them to look at results in meaningful cross-sections. They also pull stakeholders for structured interviews, in order to get an impression of the services and the population served in that area. To date, they have performed reviews in five regions of the state, and have plans to expand to other regions in the current fiscal year.
2) Performance Data Profile
The Performance Data Profile, or “dashboard” is an interface that allows them to focus on the key indicators to measure their overall performance. They can depict graphically the strength and degree of substantial conformity of areas of concern, so that they can better focus their energy and training efforts. This data can be accessed on a quarterly basis, within 15 days of the beginning of the new quarter. This helps field staff track their progress on conformity to the outcome-related indicators, and adjust policy and practice as indicated.
3) Automated CFSR Case Reading
They perform case file readings using a designated “period under review.” They review randomly selected cases, and then enter the case data through an on-line reporting tool. The tool uploads the information to a central database and quickly calculates the scores in an automated process. The results of all of the structured case readings are posted on the CPS Quality Assurance Quarterly report, with region-by-region comparison, assessable on their intranet site. An updated, Oracle-based tool is being developed internally, that will be web-enabled and provide more functionality to the user. As another part of the CFSR Case Reading effort, they have created the position of Regional Case Analyst. They are specifically trained to concentrate on the CFSR outcome measures. They receive training in using the case reading tool, as well as Texas CPS Policy Guidance. The Texas CFSR Team is currently working to solidify the roles and responsibilities of this new position.
4) DEMOS (Data-Enhanced On-line Management Support)
They have partnered with the University of Texas at Arlington, School of Social Work to develop DEMOS, using software by Speedware, an On-Line Analytic Processing (OLAP) application. Supervisors and managers can go to an Internet site and access data “cubes” that allow them to drill-down into information starting from the state-wide overview, through to regional, unit, and supervisor detail. This multi-dimensional design allows greater flexibility in analysis for the user. Currently, training is still being provided to managers and supervisors throughout the state.
One challenge faced by the team is the issue of data interpretation when utilizing “the aggregate data to drive management and practice decisions.” It is important to make sure the data accurately reflect what was meant to be measured initially, and have an understanding of the external factors (e.g. seasonality spikes) that may impact data and cause “premature” conclusions to be drawn. Additionally, it is the continued goal of the team to emphasize the importance of integrating data management with the clinical practices that direct service caseworkers provide, in order to promote an understanding of how each can impact and benefit the CPS program overall.
The tools being used in Texas are self-described as a work in progress, constantly being honed and adjusted based on trial and error, training, and user feedback. The CFSR team has gotten past the “why do we have to do this” stage with the staff, as the workers are seeing the reporting capability. They are building relationships with the users, and hope to use their feedback in order to modify the system, add reporting flexibility, and provide more education and training. These tools are helping managers manage and set the direction that line-level staff need to move towards. In subsequent years, they hope to produce more products and tools that will directly benefit workers in their every day tasking and prioritizing.
For more information about the tools that are being used in Texas, please contact Brad A. Pierson, CFSR Lead, at BRAD.PIERSON@tdprs.state.tx.us.
We hope that the Tips, Tools, and Trends series will serve to stimulate an exchange of ideas and information among States and between systems and program staff. Your feedback is important to us. If you have additional information on the topic presented in this sheet, or if you have any comments or suggestions regarding its presentation or content, please contact Tom Wetterhan of Xtria, formerly Ellsworth Associates Inc., at (703) 821-3090 x250 or tomw@xtria.com.
