Title: Best Practices for Peer Mentors Conducting an Evidence-Based Practice Fidelity Site Visit
1Best Practices for Peer Mentors Conducting
anEvidence-Based Practice Fidelity Site Visit
This product is supported by Florida Department
of Children and Families Substance Abuse and
Mental Health Program Office funding.
2Agenda
- Block Grant Requirements
- Evidence-Based Practice Fidelity Site Visit
Overview - Discussion and Feedback
- Case Studies
- Upcoming Events
3SAPT Block Grants Overview
- Block grants are noncompetitive, formula grants
appropriated by Congress. - This provides the foundation for safety net
services in Florida. - Federal grants with federal legal requirements
that apply to every aspect of the process - Department
- SAMH Program
- Contracts
- Licensing
- Revenue Management
- Budgeting
- Managing Entities
- Providers that receive federal dollars (all
providers that receive Department funding)
4SAPT Block Grant Priority Populations
- Pregnant and Parenting Women
- Intravenous Drug Users
- Individuals receiving services related to
communicable diseases (specifically Tuberculosis
and Human Immunodeficiency Virus) - Individuals receiving prevention services
5Recipients of SAPT BG Funding
6EBP Fidelity On-Site Visits
- Twenty Florida providers were randomly selected
to participate - Prior to the site visit, providers
- Conduct a self-review of a specific EBP
- Use the fidelity monitoring tool protocol
- Conduct client record reviews
- Identify areas in the agency that need
improvement - Identify areas that could benefit from technical
assistance (TA)
7Peer Mentors
- Selected based on experience and knowledge of
process improvement and specific selected EBP - Conduct on-site visits
- Complete EBP fidelity tool review reports
- Client records review
- Program review
- Identify best/promising practices used by
provider - Conduct the site visit exit interview and provide
positive feedback - Offer technical assistance as needed
8EBP Fidelity Site Visit Process
- To ensure a successful site visit agencies are
asked to - Have materials and source documents accessible
for peer mentor team - Designate a contact person
- Have staff team available to work with peer
mentors - Provide a place for the peer mentor team to work
- Invite local SAMH supervisor, managing entity or
community coalition representative to entrance
and/or exit meetings only
9Discussion Item 1
- Background of EBP Fidelity Site Visits
- Block Grant requirements
- Independent peer reviews are required by 45
C.F.R. - 5 of contracted entities must be reviewed
- Quality and appropriateness of services
- Substance abuse and mental health systems
- EPB implementation across all providers (FY
08-09) -
10Back in the Day
- Peer Review Process mandated by DCF
- 5-days long
- 2 Peer Mentors
- Audit feel to the process
- DCF attended open/exit meetings
11A New Day
- Florida won STAR-SI Grant 2006
- NIATx process improvement model
- Created an open process
- Providers/ DCF/Peer Mentors
- New EBP Initiative FY 08-09
- Created a True Peer Review Process
- Providers volunteered for visit
- 2 Peer Mentors
- 1 DCF staff present for the entire process
- Technical assistance available for providers
12Present Day
- Evolution Continues
- Providers randomly selected
- New block grant priorities checklist
- 2 peer mentors (for treatment providers)
- DCF/ME invited to attend Exit meeting
- No technical assistance available
13Discussion Item 2
- Site Visit is ScheduledNow What?
- Call provider one week before
- Ask
- Confirm contact person
- Confirm location of site visit
- Review BPP checklists are completed
- Ensure 6 client file reviews have been completed
- Ask if provider has EHR (plan for this)
- Assist provider with any questions
- Engage and create positive expectations
14Discussion Item 3
- Diversity in Staff
- It is important to have good representation of
the agency during the staff visit - There are multiple areas of review and a diverse
staff can provide more comprehensive feedback
(360 degree) - Consider who may be beneficial to participate
- Clinical Staff
- Director/Manager
- Others?
15Discussion Item 4
- Using Motivational Interviewing to Solicit
Information - Many agencies have electronic health records
(EHRs). - Its helpful to have the agency EHR staff
available during the site visit. - How should conversations about the site visit be
handled with program staff present?
16Useful MI Techniques
- Open-Ended Questions
- Asking open-ended questions helps you understand
your clients' point of view and elicits their
feelings about a given topic or situation. - Helpful with facilitating dialog
17Useful MI Techniques
- Listen Reflectively
- Reflective listening is a way of checking rather
than assuming that you know what is meant. - Check for understanding
- Is there clarity to what information is provided?
- If not, have staff walk you through some of the
navigation of the EHR.
18Useful MI Techniques
- Develop Discrepancy
- Motivation for change is enhanced when clients
perceive differences between their current
situation and their hopes for the future. - Work to raise awareness of processes which do not
align with the desired outcome. - For example, you would like to demonstrate the
clients are benefiting from the EBP but the EBP
is not discussed in the clinical record (progress
note).
19Useful MI Techniques
- Affirm
- Support the self-efficacy of the agency by
affirming the work that is done. - For example, you are doing a good job with X.
How can we make sure to capture the work you are
doing?
20Discussion Item 5
- On the best/promising practice (BPPs) checklists,
which questions are key in identifying if BPPs
are being implemented by an agency?
21What Do You Do?Case Studies
- Youre conducting an EBP fidelity site visit and
youre about to review the best/promising
practice checklists. The provider informs you
that none of the checklists apply to their work.
What do you do?
22What Do You Do?Case Studies
- Upon arriving for the site visit, you discover
that the provider has not adequately briefed
their staff. They are unaware of the purpose of
the site visit and they have not completed the
client reviews or the best/promising practice
checklists. What do you do?
23Peer Mentor Teleconference Calls Schedule