Implementation of the WFI-EZ in a
Multi-Site Wraparound Agency
March 3, 2014
Choices
• Care Management Entity
– System of Care
– Wraparound
– Managed Care
• Established in 1997
• Over 1500 youth served
daily
Agenda
• Choices experience with the WFI
• Integrating the WFI-EZ into Practice
• Using the WFI for Quality Improvement
Experience with WFI 3.0 and 4.0
• Wraparound Comparison Study
– Dawn Project
– University of Maryland
• Choices Technical Assistance Center
– Subcontractor
– Choices Outcomes and Evaluation Staff
Experience with WFI 3.0 and 4.0
• Advantages
– External evaluation
– Trained interviewers
– Alignment with phases and principles
• Disadvantages
– Staff resources
– Completion rates
– Limited assessment options
WFI-EZ
• Short-form
– Wraparound Fidelity
– Youth Outcomes
– Satisfaction
• Self-Report
– Paper
– On-line
– Interview
Part 1
Integrating the WFI-EZ into Practice
Administration Options
• On-line
– Care Coordinators introduce
– Email to caregivers
– Survey Monkey
• Challenges
– Caregivers have limited access to Internet
– Reading levels
Administration Options
• Paper
– Care Coordinators introduce
– CCs give survey to families
• Sign sealed envelope and return
• Mail in stamped envelope
• Challenges
– Potential for bias
– Reading levels
Administration Options
• Interviews
– Program staff
– CCs introduces
– Conducted by phone
• Challenges
– Resource cost
– Successful contacts with caregivers
– WFI-EZ format
Implementation Process
• Allowed sites to select method
• Generated random samples
• CCs completed WFI-EZ on one youth
• 30 days to get completed surveys from
caregivers
Results
• 3 of 4 sites selected paper surveys
• 1 site conducted phone interviews
• Response rates
– Interviews (44%)
– Paper (22-36%)
Results
• Consistent data quality
• Bias from CC involvement not observed
• Cost/benefit analysis
Next Steps
• 2nd administration underway
• Improve CC introduction to WFI-EZ
• Formalize mechanism for returning paper
surveys
• Incentives for caregivers and youth
Part 2
Using the WFI-EZ for Quality Improvement
Importance of the WFI-EZ
• Family voice
• Fidelity monitoring vs. task management
• Opportunities for quality improvement
Quality Improvement
• Multiple levels of analysis
• Opportunities for celebration
• Common areas for improvement
• Site-specific strengths and needs
Total Caregiver Fidelity Score
High Fidelity (85% and above)
Good Fidelity (75% - 84%)
Adequate Fidelity (65% - 74%)
Not Wraparound (Below 65%)
WFI Louisiana - October 2013
18
Wraparound Fidelity Principles
100%
90%
High
80%
Good
70%
Adequate
60%
Not
Wraparound
50%
40%
30%
20%
10%
0%
Outcomes
Based
Teamwork
Natural
Supports
Needs Based Strength and
family driven
WFI Total
Score
Wraparound
Strength and Family Driven
100%
90%
High
80%
Good
70%
Adequate
60%
Not
Wraparound
50%
40%
30%
20%
10%
0%
B1: Had a major
B3: Family
B11: Celebrate B14: Strategies B17*: Team
Strength and
role in choosing described vision successes at
tied to family members do not family driven
team
each meeting
likes
understand
Overall
family
Wraparound
Satisfaction
I am satisfied with the wraparound process in which my family and I have participated.
100.0%
90.0%
% of Caregivers Strongly Agree or Agree
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
DC
Indiana
Louisiana
Maryland
Choices
Outcomes
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Cause stress or strain on
family
Disrupt home life
Interfer with success at
school
Difficulty developing
friendships
Difficulty participating in
community activities
Quality Improvement
• Multiple Levels
– Agency
– Programs
– Teams
• Multiple Data Sources
– Fidelity
– Process measures
– Outcomes
Conclusions
• Integrate WFI-EZ into practice
• Balance response rates and resources
• Quality improvement requires multiple types
of data
• Ongoing assessment is important
Thank You!
Vicki Sprague Effland, Ph.D.
Director, Outcomes and Evaluation
Choices, Inc.
4701 N. Keystone Ave., #150
Indianapolis, IN 46205
(317) 205-8232
Veffland@ChoicesTeam.org