Best Practices for Peer Mentors Conducting an Evidence-Based Practice Fidelity Site Visit - PowerPoint PPT Presentation

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Best Practices for Peer Mentors Conducting an Evidence-Based Practice Fidelity Site Visit

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Confirm contact person Confirm location of site visit Review BPP checklists are completed Ensure 6 ... If not, have staff walk ... Work to raise awareness ... – PowerPoint PPT presentation

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Title: Best Practices for Peer Mentors Conducting an Evidence-Based Practice Fidelity Site Visit


1
Best Practices for Peer Mentors Conducting
anEvidence-Based Practice Fidelity Site Visit
  • January 23, 2015

This product is supported by Florida Department
of Children and Families Substance Abuse and
Mental Health Program Office funding.
2
Agenda
  • Block Grant Requirements
  • Evidence-Based Practice Fidelity Site Visit
    Overview
  • Discussion and Feedback
  • Case Studies
  • Upcoming Events

3
SAPT 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)

4
SAPT 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

5
Recipients of SAPT BG Funding
6
EBP 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)

7
Peer 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

8
EBP 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

9
Discussion 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)

10
Back 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

11
A 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

12
Present 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

13
Discussion 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

14
Discussion 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?

15
Discussion 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?

16
Useful 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

17
Useful 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.

18
Useful 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).

19
Useful 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?

20
Discussion Item 5
  • On the best/promising practice (BPPs) checklists,
    which questions are key in identifying if BPPs
    are being implemented by an agency?

21
What 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?

22
What 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?

23
Peer Mentor Teleconference Calls Schedule
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