Quality Improvement and Quality Assurance Database Development

1
Quality Improvement and Quality Assurance
Database Development
Katherine A. Shecora, MSW Continuous Quality
Improvement Coordinator, Children's Service,
Inc., Philadelphia, PA Ph.D. Student, University
of Pennsylvania School of Social Work
2
Relevance

• Database development serves as tool for
  aggregating data
• Annual reports disseminate aggregated data
• Funding agencies rely on aggregated data to
  determine consumer needs
• Maintaining a comprehensive and secure database
  system will facilitate decision making both
  internally and external to the organization

3
Introduction

• The relationship between Continuous Quality
  Improvement and Database Development
• Accreditation
• Funding Requirements
• Databases as Tools

4
Training Methods and Overview

• Lecture
• Handout Materials
• Group Discussion

5
Agenda

• Phase I Data Management-From the Beginning
• Phase II Asking Questions
• Phase III Realities

6
Phase I Data Management

• From the Beginning

7
Technical Skills Required for Successful Database
Development

• Computer literacy
• Familiarity with summary statics
• Database construction in MS Access, Corel
  Paradox, or Lotus Approach
• A solid understanding of systems theory in
  relation to service delivery

8
Procedural Starting Points

• Review the Council on Accreditation G2
  Requirements (especially G 2.10) or similar
  accrediting bodies' requirements
• Examine the agency mission, vision and ethics
  statements
• Realistically assess the fiscal and labor costs
  for data collection and measurement

9
Procedural Starting Points (continued)

• Look at the corporate culture within the social
  service agency
• Is the agency open to new ideas?
• Does the corporate culture allow for openness and
  an exchange of ideas within the professional
  realm?
• Do the workers strive to fulfill the agency
  goals?
• Engage in strategic planning

10
What is the reality?

• What are the fiscal resources available?
• Does the data management process receive support
  from vested parties?
• Who are the projects opponents?
• Why are the parties opposed?
• What training resources are available?

11
Barriers to Implementation

• Perceptions of computerization
• Vehicle for determinism
• Against consumer choice
• Computing infrastructure inadequate or not
  existent
• Cost
• The need for staff training
• Data Entry
• Data utilization

12
Phase II Asking Questions

• Setting the foundation

13
What is the agency function?

• What services are provided in the agency?
• Adoption
• Foster Care
• Medical Care
• Psychiatric and Behavioral Health Services
• Geriatric Care

14
Who (or what) is the client?

• The Community
• The Family Unit
• The Individual Person
• Adults
• Children

15
What service delivery method does the
organization use?

• Clinical mode
• Individuals
• Groups
• Families
• Case management
• Community organizing

16
Organizational Goals and Data Collection

• What do we need to know?
• Why do we need to know it?
• How will data collection further these goals?

17
What are the basics we need to know?

• Individual Demographics
• Date of birth
• Race
• Gender
• Educational level attained
• Labor force participation
• Family Configuration

18
What are the basics we need to know? (Continued)

• Families (for each family member)
• Date of Birth of each household member
• Racial identity
• Gender
• Educational level attained
• Labor force participation
• Position within the family configuration

19
What are the basics we need to know? (Continued)

• Community Services
• Age distribution within the community
• Racial composition
• Gender distribution
• Educational levels
• Labor force participation
• Identification of community leaders

20
Example Which entities comprise the client's
support system?

• Family members
• DHS workers
• Parents
• Siblings
• Foster parents

21
Example Which entities comprise the client's
support system? (Continued)

• The Client's Extended Family
• The Client's Family of Choice
• Clinical Staff
• Case Managers
• Child Advocates

22
Phase III Realities

• Tracking issues
• CQI and QA

23
Longitudinal development and tracking for all
services

• Goals
• Objectives
• Outcomes

24
Continuous Quality Improvement and Quality
Assurance Issues

• Intake documentation
• Record maintenance
• Community contacts
• Fiscal information

25
Continuous Quality Improvement and Quality
Assurance Issues (Continued)

• Peer review
• Utilization review
• Consumer satisfaction

26
Conclusion

• For data management to be successful, the process
  must be ongoing and proactive in nature. As with
  CQI processes, communication between the
  developer and the user is paramount. Feedback is
  important, as it helps ensure the maintenance of
  a system that functions within the ethical
  parameters of the social service professions.