CONTINUOUS
QUALITY
IMPROVEMENT
(CQI)
CQI Case Review Training Rev 7/11
CQI is a standard of practice
designed to achieve the
following…
Assure each child and family member receives
the most effective and best quality services
Provide necessary feedback for design and
delivery of services
Identify needs for training, policy
development, and system improvements
Assure services meet state and federal
standards
CQI Case Review Training Rev 7/11
Overview of CQI
Components
CQI Case Review Training Rev 7/11
INTERNAL REVIEW
EXTERNAL REVIEW
CASE REVIEW
CQI Case Review Training Rev 7/11
INTERNAL REVIEW
 FOCUS reports
 90-day Concurrent Planning Reviews
 27-day reviews (Region 3)
 Case staffings/Supervisory reviews
 FOCUS alerts
 Fatality reviews
CQI Case Review Training Rev 7/11
EXTERNAL REVIEW
5 year Comprehensive Child and
Family Services Plan/Annual Report
Input/feedback from community
partners
Judicial reviews
Title IV-E Plan
Constituent complaints
CQI Case Review Training Rev 7/11
CASE REVIEW
 Standardized (federal) instrument
 Random sampling of cases
 Reviewer teams
 Mandatory training for reviewers
 Second level reviewer
 Immediate worker feedback
 Interviews
 Line staff and sups as reviewers
CQI Case Review Training Rev 7/11
Case Review Team
 Regional Chief(s) of Social
Work
 Case Reviewers
 Community partners such as Casey
Family Programs, University
Partners, KCS panel members
 Second Level Reviewers
CQI Case Review Training Rev 7/11
CASE SELECTION
CQI Case Review Training Rev 7/11
 Only open cases will be reviewed
 Half of the cases will be in- home
cases, open for at least 60 days
 Half of the cases will be children
in out-of-home placement
 Reviewers will use information
from FOCUS and the nonelectronic case file
CQI Case Review Training Rev 7/11
CQI Case Review Toolkit
 Case Rating Form
(electronic or hard copy)
 Case Rating Summary
 Examples of questions
for interviews
 Rating tip sheets
CQI Case Review Training Rev 7/11
Before the Review
Training is mandatory!!!
Be familiar with the case review
instrument.
Arrange coverage for your
cases.
Get a good night’s rest when
possible.
CQI Case Review Training Rev 7/11
During the Review
 Manage your time effectively
 Eat healthy and regularly to stay sharp
 Complete one case before going on to
another when possible
 Leave your “stickies” on – they are only
removed by second level reviewers
CQI Case Review Training Rev 7/11
During the Review
 Re-check your work before submitting
for second level review
 Be prepared to work early and late
 Practice the Principles of Partnership
 During the case review, ratings will be
collected as they are completed.
 Be sure to complete the strengths,
weaknesses, systemic and training issues
CQI Case Review Training Rev 7/11
After the Review
 You may be able to leave the
review when cleared by the
second level reviewer
 Information about cases is to be
shared only on a “need to know”
basis.
CQI Case Review Training Rev 7/11
INTERVIEWS
CQI Case Review Training Rev 7/11
What to ask in interviews
 How involved in case planning
 Frequency and quality of worker
visits
 Needs identified and services to
address those needs provided
 Respected, listened to, valued
 Fill in spots where info is missing
See Interview question tip sheet
for additional suggestions.
CQI Case Review Training Rev 7/11
Time to Practice
CQI Case Review Training Rev 7/11
SAFETY
 OUTCOME S1: Children are first and
foremost protected from CA/N
 ITEM
1 – Timeliness of Investigation
 ITEM
2 – Recurrence of Maltreatment
CQI Case Review Training Rev 7/11
SAFETY
 OUTCOME S2: Children are safety
maintained in their home whenever possible
 ITEM
3 – In-home services to prevent
removal
 ITEM
4 – Risk of Harm
CQI Case Review Training Rev 7/11
CQI Case Review Training Rev 7/11
Permanency
 OUTCOME P1: Children have permanency
and stability in living situation
 Item 5 – Foster care re-entry
 Item 6 – Placement stability
 Item 7 – Permanency goal for child
 Item 8 – Reunification or guardianship
 Item 9 - Adoption
 Item 10 – Other Planned Permanent Living
Arrangement
CQI Case Review Training Rev 7/11
Permanency
 OUTCOME P2: The continuity of family
relationships and connections is preserved
 Item11 – Proximity of placement
 Item 12 – Placement with siblings
 Item 13 – Visiting with parents and sibs
 Item 14 – Preserving connections
 Item 15 – Relative placement
 Item 16 – Relationship of child in care with
parents.
CQI Case Review Training Rev 7/11
CQI Case Review Training Rev 7/11
Well-Being
 OUTCOME WB 1: Families have enhanced
capacity to provide for their children’s
needs
 Item 17 – Needs and services
 Item 18 – Child and family involvement in
case planning
 Item 19 – Caseworker visits with child
 Item 20 – Caseworker visits with parents
CQI Case Review Training Rev 7/11
CQI Case Review Training Rev 7/11
Well-Being
 OUTCOME WB 2: Children receive
services to meet educational needs
 Item
child
21 – Educational needs of the
CQI Case Review Training Rev 7/11
Well-Being
 OUTCOME WB 3: Children receive
services to meet physical and mental
health needs
 Item
22 – Physical health of the child
 Item
23 – Mental/behavioral health of
the child
CQI Case Review Training Rev 7/11
Results
 When all case reviews are completed, the
review team will enter the data from the
summaries onto an Excel spreadsheet so
that results will be available immediately.
They will also review and summarize the
Strengths, Areas Needing Improvement,
Systemic and Training Issues identified
by the reviewers.
CQI Case Review Training Rev 7/11
Feedback to Social Worker
and Supervisor
CQI Case Review Training Rev 7/11
Case reviewers will provide feedback to
the social worker whose case has been
reviewed together with the worker’s
supervisor.
CQI Case Review Training Rev 7/11
Providing effective
feedback
Maintain a strength based
perspective – what was done right?
What is working?
Be kind, firm, and courageous in giving
feedback
Being as specific as possible is always
the most useful feedback
CQI Case Review Training Rev 7/11
CQI Exit Meeting
 PURPOSE of the exit meeting is to give
feedback to the region on the results of
their case review.
 WHO should attend? All regional staff
including supervisory and management
staff, case reviewers when possible,
second level reviewers and anyone else who
may be interested
CQI Case Review Training Rev 7/11
 WHAT - Regional Chief of Social
Work will present a summary of
findings to the group including
identified strengths, systemic issues,
areas needing improvement and
training issues.
CQI Case Review Training Rev 7/11
Following the case
review
 The regional management team will review
the results including the practice
strengths, ANI’s, and systemic issues as a
group. They will also review other sources
of data related to issues found in the case
review. All together, this information
should lead to a discussion of improvement
planning.
CQI Case Review Training Rev 7/11
Continuous Quality Improvement
Monitor Plan
Implement Plan
Measure change
Plan Development
Establish baseline
Evaluate Practice
Improvement and
Outcome
Achievement
Assessment and
Data Analysis
Re-assess
CQI Case Review Training Rev 7/11
You have completed
your training….
CQI Case Review Training Rev 7/11
and
CQI Case Review Training Rev 7/11