Transcript Tamar Zemach-Marom "Quality Improvement and Performance

Quality Improvement and
Performance Measurement
in Social Services in Israel
Tamar Zemach-Marom
June 2011
1
Main Goals of the RAF Method
1. Monitor adherence to the standards and regulations
2. Encourage continuous improvement at all levels
3. Enhance management capacities of the care facilities
4. Provide database for policy making
2
Services Utilizing the RAF Method
Residential settings for:
• The aged
• Children at risk
• Juvenile offenders
• Physically disabled
• Developmentally disabled
• People struggling with alcohol, drug and gambling
addictions
Services in the community:
• All community services for children and youth at risk
• Rehabilitative preschool facilities for disabled children
• Service for treatment of addictions
• Social Service departments at the municipalities
3
Prior to RAF :
 The regulatory process: not systematic and not uniform
 Hardly any written documentation for inspection and care
facilities
 No systematic data collection
 Inspectors serving mainly as advisors
4
Multi-Annual Inspection, according to the RAF Method
Year of Comprehensive Inspection
Process
1. Collecting client data
Year without Comprehensive Inspection
Process
1. Collecting client data
Regular inspector visits
Regular inspector visits
2. Analyzing client data and producing
reports
Regular inspector visits
2. Analyzing client data and producing
reports
Regular inspector visits
3. Constructing personal care plans
3. Constructing personal care plans
Regular inspector visits
Regular inspector visits
4. Collecting additional data
4. Collecting additional data
Regular inspector visits
Regular inspector visits
5. Comprehensive inspection process
Comprehensive visit
Feedback to the facility &
constructing a yearly work plan
Initial follow-up
Regular inspector visits
6. Internal quality assurance processes
Regular inspector visits
7. Decisions about licensing the facility
Index:
Inspection processes
Processes at the facility
5. Constructing a yearly work plan
Regular inspector visits
6. Internal quality assurance processes
Regular inspector visits
7. Decisions about licensing the facility
Types of Data Provided by the RAF System
1.
Data on clients


2.
Data on quality of care in the
facilities, regarding:




3.
Demographic and administrative data
Profile of their problems (tracers)
Treatment
Management
Infrastructure
Client's perspective
Information on implementing
inspection

Meeting work plan requirements
6
The Impact of the RAF: The Inspection Level
1. Creating uniform and systematic tools for
inspection
2. Streamlining the process of regulation
3. Transparency and improved dialogue with the care
facility
4. Incorporating the client viewpoint as part of the
regulation process
5. Decisions based on data
6. Help in dealing with irregular incidents
7
The Impact of the RAF: The Level of the Care Facility
1.
2.
3.
4.
5.
An enhanced sense of fairness
Improved service
Improved record keeping
More structured work procedures
Triggering organizational learning processes and
data-based decision making
8
The Impact of the RAF: The Service Management Level
1. Data-based policymaking
2. Upgrading standards and regulations
3. Creating a common language and basis for
comparison
4. A solid base for steps of enforcement
5. Improving the ability to monitor the regulation
process
9
Contributing Factors for Successful Implementation
1. Awareness and motivation to change
2. Commitment of the leadership
3. True partnership between people in the field and the
advisory body
4. Gradual implementation
5. Providing resources and infrastructure
6. Using opinion leaders to serve as agents of change
7. Flexibility
8. Presenting data in a user friendly way
9. Immediate response to obstacles
10
Thank You
11
The Ministry of Social Affairs
The RAF System
The Children and Youth Services
Sample Report
I.D.
List of
Tracers
Family
Name
First
Name
Gender
Age
M
10
M
10
M
9
F
10
F
9
M
7
M
10
M
11
M
13
F
10
F
11
F
10
1
2
3
4
5
6
7
8
9








10
11
12
13
14

























1. Low achievement
at school
3. Running
away
5. Problematic
relations with family
7. Problematic
social behavior
9. Enuresis
11. Drug abuse
13. Suicidal
behavior
2. Behavior at
school
4. Physical
self-neglect
6. Aggression
8. Theft
10. Alcohol use
12. Depression
and anxiety
14. Problematic
sexual behavior
No problem




Having no difficulty with tracer
Difficulty with tracer – no change from the previous year
Difficulty with tracer in previous year – improvement noted this year
12