	Performance and Quality Improvement

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-PQI 3: Support for Performance and Outcomes Measurement*

An inclusive approach to establishing measured performance goals, client outcomes, indicators, and sources of data ensures broad-based support for useful performance and outcomes measurement.

Note: Please see Worksheet: Initial PQI Review, Worksheet: PQI Operational Procedures_ and Tip Sheet: Operations Measures Private in the Tools Index for additional assistance with this standard.

PA-PQI 3.01

Senior managers and supervisors set forth performance and outcome expectations in a supportive manner and allay concerns about possible repercussions of identifying areas in need of improvement.

PA-PQI 3.02

Staff throughout the agency and stakeholders, including partners and contractors, work together to:

develop key outcomes and outputs;
develop relevant qualitative and quantitative indicators; and
identify data sources, including measurement tools and instruments.

Interpretation: Outcomes, outputs, indicators, tools, etc., may reflect reporting obligations, and for some services, may be established by contractual requirements.

The agency, depending on length and level of experience measuring outcomes, will start building a successful measurement system by using one or two measures of qualitative and quantitative data, if possible, for a few strong indicators. However, at minimum, performance and outcomes measures must be identified for high-risk services such as protective services, foster care, residential treatment, etc.

Note: Please see Tip Sheet: Stakeholder Involvement in the Tools Index for additional assistance with this standard.

PA-PQI 3.03

The agency selects performance measurement indicators that relate to operations and management, program results, and client outcomes.

Interpretation: Examples of operations and management performance indicators could include:

financial viability;
system efficiency;
effectiveness of risk prevention measures; and
staff retention and job satisfaction.

Service delivery indicators influencing program results could include:

timeliness and comprehensiveness of individualized assessments;
family involvement;
client satisfaction; and
staff training.

Interpretation: For networks, in addition to the measures that address client outcomes and important dimensions of service delivery, the network may also measure important network administrative processes, such as:

the average length of time between receiving a clean claim and paying the claim;
the proportion of services that are evidence-based or meet nationally recognized treatment guidelines developed by consensus groups;
the effectiveness of network training;
the satisfaction of stakeholders, such as high volume referral agents (e.g., judges, court workers, employee assistance agents);
penetration rates, or the proportion of the whole population eligible to be served by the network who actually receive services; and
results of retrospective case record reviews, including the percentage of charts in which a placement decision includes an appropriate application of clinical criteria.

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	PURPOSE: An agency-wide Performance and Quality Improvement (PQI) program advances efficient, effective service delivery and the achievement of strategic and program goals.

RELATED FILES


	PERFORMANCE A measure of how well an organizational system provides services to consumers. Performance is often based on key indicators, such as rates of service, cost per consumer, degree of satisfaction with services, and extent of consumer access to services.


	QUALITY In this context, the extent to which contemporary and generally recognized standards for professional practice are met and exceeded, and desirable service outcomes achieved.


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	INDICATOR A described activity, event, outcome, or benchmark used for measurement in monitoring the quality and outcome(s) of service.


	STAKEHOLDER Any person, group, or organization that has a vested interest in the services provided by the organization. Examples: clients, consumers, personnel, funding organizations, referral organizations, vendors, and governmental bodies.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	TRAINING Instruction so as to make fit, qualified, or proficient in a skill or body of knowledge.


	CLIENT See service recipient.


	MANAGEMENT See ADMINISTRATION


	EMPLOYEE Paid member of an organization. Foster parents are not considered employees and are specifically referenced in relevant standards.


	CASE RECORD A written compilation that describes the client and the services delivered. Records can be in hard copy and/or electronic format. The case record can be used as a source of information for quality improvement or other evaluation activities, for research purposes, or to demonstrate accountability to funding bodies.


	CLINICAL The study, assessment, and diagnosis of the client situation followed by direct treatment to help the client achieve prescribed goals.


	CRITERIA Systematically developed, objective, and quantifiable statements used to assess the appropriateness of specific decisions, services, and outcomes.