Building Grassroots Involvement in QI Projects

1
Building Grassroots Involvement in QI Projects

• Title I Quality Learning Network Presentation
• Carla Lewis, Ph.D.
• Director of Planning and Evaluation
• Project Hospitality
• August 1, 2006

2
Championing Innovation from the Bottom Up

• Caseworker Creativity New Technology Workshops
  (state-of-the art tools, working smart,
  leveraging pre-existing data to tell a story -
  see agenda)
• To facilitate learning of new techniques and
  shifts in thinking about quality improvement
• To empower staff with a skill set to understand
  quality and culturally competent programming
• To generate possibilities and the motivation to
  engage in collaborative team driven QI projects

3
Championing Innovation from the Bottom Up

• Grassroots Gems Using data from Consumer
  satisfaction reports to craft QI projects and
  more meaningful, focused work.
• Problems/Solutions Joining staff where they are
  at
• The Vision, the Reality
• Taking it down a Notch and surprises from the
  field

4
The Bridge to Life QI Project

• Criteria
• Inclusive (consumer/staff)
• data driven
• goal oriented to increase engagement in group
  sessions for HIV Mental Health consumers at our
  one stop shopping SHINE Center
• Consumer Survey Results
• raising the bar-- More intensive, therapeutic
  work indicated for dually diagnosed (SPMI)
  consumers to maintain retention in critical
  services.
• More resources are needed for higher functioning
  clients. Its not like 20 years ago. We can
  achieve so much more even with the disease
• Fine tuning programming to fit special needs
  subgroups is especially meaningful for consumers
  at the extreme end of the spectrum (3 to 5 years)
  according to quantitative and qualitative
  analyses of survey data.

5
The Bridge to Life QI Project (continued)

• QI Action Plan
• separate groups with clients from each end of the
  continuum (new and over one year)
• More focused work with long term clients who may
  be struggling with high expectations, coasting,
  or redundant group work with newly diagnosed
  clients
• Rapid Cycle Pilot Test
• Invitations to a Bridge to Life closed group
  will be distributed
• Designated Popular Opinion Peer Leaders will
  share and encourage participation
• Post intervention group satisfaction feedback
  will be assessed.

6
Rapid Cycling Derived from Special Populations
Consumer Surveys

• Target group Sheltered, HIV , mentally ill,
  substance abusing clients.
• Survey Recommendations
• More explicit and structured delivery of life
  skills services
• Greater attention to consumer readiness, and
  distractibility
• Built-in feedback mechanisms to facilitate more
  responsive and adaptive service delivery
• Separating out life skill domains (e.g. hygiene,
  self care) with specific interventions and
  feedback mechanisms - a joint QI initiative for
  the OConnor team
• Establishment of baselines to gauge what works
  and does not work for each consumer

7
Program QI Response

• Intervention/Solution
• Staff implemented a highly promoted, explicitly
  labeled community topic meeting (e.g. self
  care, hygiene) with evaluation component
  (accompanied by shopping excursion)
• Results
• Pre Intervention - perceptions of life skills
  service delivery was below quality standards.
• Post intervention - 100 of consumers were able
  to identify 3 important self care/life skills and
  7 out of 8 (88) felt the activity would help
  them when they moved into transitional or
  permanent housing

8
On Buy-In and Future Directions

• The Quality Infrastructure
• Trial and Error, Shuffling stakeholders
• Putting QI on the radar day-to-day
• Building teamsmanship (Peer in-reach)
• New and Sustained QI Projects (the point person)
• Shifts in Consciousness