Improving Systems, Practices, and Outcomes

State Scenarios: Accountability and Quality Improvement

Consider this scenario...

Your state is planning to revise the current general supervision system to move from the strictly compliance focus of the last 20 years to one that includes program quality and improved performance. Local providers are very pleased about this shift, although they express some worry about their responsibility for child outcomes improvement. There is also some general concern that maintaining the continuing requirements related to compliance will make this shift difficult to achieve given limited state resources.

Glossary terms are denoted with a book icon, and link to their respective glossary entries.

Sample Process:

Being generally familiar with the System Framework Self-Assessment as a means to target needed changes, you review the Guidance Document and decide to convene a group of relevant stakeholders to complete the Self-Assessment for the Accountability and Quality Improvement Component. This will provide baseline information about what aspects of your Accountability system are strong and what areas should be improved.

In reviewing the Accountability and Quality Improvement Component, your stakeholders group decides to focus their analysis on Subcomponent 1: Planning for Accountability and Improvement.

Screenshot: Self-Assessment (Excel Worksheet)

As a result, the Self-Assessment determines that Quality Indicator AC2 contains the elements in need of improvement to respond to the challenge faced by your state. This will assist your state in revising your current compliance focused general supervision system to one that incorporates both compliance and quality improvement.

In completing the Self-Assessment, your stakeholders group identified the level of implementation for each of the Elements of Quality under Quality Indicator AC2 along with supporting evidence.

Your team uses the results of the Self-Assessment to identify what needs improvement or modified to ensure that a general supervision system focusing on both compliance and quality improvement is doable for you and your local programs. The information is used to help set priorities for your action planning and implementation.

Specifically, you determine that you have a clear accountability plan that needs revisions to include a focus on quality improvement and improving results for children and families. Your goals, current targets, benchmarks, indicators, and performance measures need to be modified to balance the focus on compliance with quality improvement. Modifications also need to be made to your mechanisms for collecting valid and reliable data. To accomplish this, you form a work group, including stakeholders from other state agencies, your provider community and families to begin making these modifications to your accountability and quality improvement system plan.

In summary, the System Framework and the Self-Assessment are tools you can use to identify areas of improvement to enhance your system of services.

ECTA recommends you complete the Self-Assessment for the entire System Framework. But you may decide to complete just the Accountability and Quality Improvement Component, or a specific Subcomponent, but always consider how the System Framework Components interact with each other. Remember, the components are not stand-alone. Even though your challenge is related to the Accountability and Quality Improvement Component, developing a cross-sector training and TA system will impact on other components of the System Framework such as Finance, Governance, and Personnel/Workforce.

Don't hesitate to call on your TA providers for assistance in using the System Framework and Self-Assessment, including:

  • Stakeholder selection and communication
  • Stakeholder meeting facilitation
  • Priority selection of activities to address improvement
  • Action planning and implementation
  • Evaluation of state efforts

Finally, use the information provided in Considerations for Implementing System Change to help guide implementation of your improvement plan activities to improve your Personnel/Workforce system.

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