Using management systems to improve services

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Using management systems to improve services

• A tale of three initiatives lifesharing,
  employment and independent monitoring

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The three initiatives

• Lifesharing. People who want to live together
  getting the home and community services and
  support they need.
• Employment. Youth and adults getting the support
  they need to secure community jobs
• Independent Monitoring for Quality. The
  community taking responsibility for the quality
  of the support that their citizens receive.

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Stats
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Common Qualities

• Lifesharing, employment and independent
  monitoring each
• Support choice, control and other everyday life
  principles we follow, like inclusion and social
  responsibility
• Promote outcomes that directly affect the quality
  of a persons life as the essential measure of
  success
• Express socially valued forms and work in
  mutually enhancing and cohesive ways

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Common Challenges

• Lifesharing, employment and independent
  monitoring each face challenges with
• The system - status-quo policy, administration,
  programs and practices
• Community integration and interface when
  participation is essential to success
• Using quality measures to continuously improve

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Common Forces

• Families of younger people have different
  expectations
• Educational practices promote inclusion and
  employment outcomes
• Recognition of new quality management measures

• Recognition that new approaches are needed for
  self-determination
• Community acceptance of people with disabilities
  in the community
• Cost effectiveness

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Management Frameworks

• LIFESHARING,
• EMPLOYMENT and
• IM4Q
• each have

• State funding , policy, and guidelines
• Standard ISP related practices and connections
• External review, QI and reporting requirements
• Communities of practice
• Communication networks
• Management Information Systems
• Training and TA

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IM4Q SYSTEM

• FUNCTIONS
• - Web-Based DATA ENTRY and Reporting
• - NCI Interface
• - Developed to improve satisfaction and outcomes
  on the state, county and provider levels
• - Emphasis on networking, communication, training
  and external evaluation

• CURRENT EMPHASIS
• Standard Closing the loop practices
• Domain score reporting
• Data entry of text
• Communication with people who dont speak
• Piloting new realms
• Improving considerations and reports
• Interface with quality councils

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BIG IM4Q Challenges

• Getting agencies to use data for quality
  improvement purposes
• Getting the systems attention to focus on
  outcomes and satisfaction
• Improving the quality of considerations and
  linkage to ISP process

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LIFESHARING AND EMPLOYMENT

• DEVELOPMENT AREAS
• Applying standard ISP and strategic planning
  practices
• Applying new service definitions, funding,
  waiting list and review protocols

• Assisting youth and young adults, and people in
  community program into employment
• Using Review Procedures
• Creating a statewide training and ta networks

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BIG Employment and Lifesharing Challenges

• Moving from a facility based to community based
  service and support structures
• Engaging employers using customized employment
  approaches
• Continually addressing the barriers

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Our Message Continually Raise Expectations

• New service approaches affect all stakeholders
• The system needs to work in community to improve
  outcomes
• Expectations to raise the bar apply across the
  board

• Quality, lifesharing and employment are
  everyones responsibility.
• Collaborate, work together to form an accountable
  union, be innovative, reframe

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State Management Has Changed

• Alignment of quality improvement initiatives and
  quality measurement led by one QI Initiative
  Division.
• Management of quality improvement initiatives on
  another track than CMS Waiver and other
  compliance actions.
• Building program integrity through standard
  practices developed through community based
  coalitions

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Where to Now

• Greater reliance on strategic planning and
  innovation at the provider level
• Greater reliance on coalitions and communities of
  practice to address system issues
• Greater standardization of practices to promote
  QI outcomes
• Greater use of data to test and refine delivery
  systems
• More lifesharing, employment, and independent
  monitoring for quality.

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What to Take Away

• Accountability to a persons / familys outcomes
  matters most
• The persons choice through the ISP process
  drives change
• Service system practices must support socially
  valued outcomes like employment and lifesharing
  for people to be self-determined
• Quality of life and outcome assessments are in
  the venue of community support

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For More Information

• Dana Olsen
• Director of Quality Improvement Initiatives
• Pennsylvania Office of Mental Retardation
• PO Box 2675
• Harrisburg PA 17120-2675
• 717-772-4315
• dolsen_at_state.pa.us