Slide 1 Welcome - Indiana Child Welfare Education and...

QSR: FCM Orientation Computer Assisted Training

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Slide 1 ‐ Welcome

Audio Script:

Welcome to the Quality Service Review, also referred to as QSR, FCM Orientation computer assisted training. During this training you will be provided with step‐by‐step guidelines that will assist you with your case preparation for the QSR.


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Slide 2 ‐ Training Objectives

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This training will provide you with information about the purpose of the QSR, an overview of the QSR process, directions on how to obtain the releases of information, information that will assist you in preparing the Case Summary, Case Schedule, and Case Binder, and other important information for you to remember as you prepare for the QSR process.


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Slide 3 ‐ Purpose Title Slide

Audio Script:

What is the purpose of the QSR?


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Slide 4 ‐ What is the Quality Service Review (QSR)?

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The purpose of the QSR is to provide a thorough assessment of a case based on conversations with key case contributors, in a structured interview process. The process has three focus areas which review the child status indicators, parent‐caregiver status indicators, and the system performance indicators. The data collected during the QSR provides DCS with essential regional, and statewide information to assist with continued practice improvement.


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Slide 5 ‐ What is the purpose of the QSR?

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The QSR also serves as a catalyst in promoting learning at all levels within DCS, and throughout the community. One of the main goals is to examine what about our current approach is working, or not working, for our children and families and why, or why not. The system as a whole has the opportunity to communicate our practice model expectations with our families and community stakeholders, realizing that there is still work to be done before it reaches its full potential. The data collected helps maintain regional and statewide baselines for DCS practice improvement.


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Slide 6 ‐ What does the QSR mean for you?

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You will be responsible for gathering and compiling the information necessary to complete a thorough review of a randomly selected case. The case selected will provide a sample of the regional trends, as well as the system changes required to support the practice model both within DCS, and with our system partners. There will not be any disciplinary action taken based upon the results of the QSR data.


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Slide 7 ‐ Overview Title Slide

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The following slides will provide an explanation of the case selection criteria, and the schedule of the QSR week.


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Slide 8 ‐ Case Selection Criteria

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Cases are selected for the QSR based on the age of the child, the amount of time a child has been in care, the type of placement that the child currently resides, and the type of case; for instance, IA, CHINS, or Assessment.


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Slide 9 – QSR 5‐Day Review Schedule

Audio Script: The QSR takes place during a designated week beginning on Monday morning, and ending by noon on Friday. Cases are selected to be reviewed on either Monday/Tuesday or Wednesday/Thursday. On Day 1, the reviewers will first meet for Reviewer Orientation. Following the Reviewer Orientation, the review teams will review the case records from their Monday/Tuesday case that has been provided in the binders. After reviewing the records for the case, the review teams will begin their interviews. The first interview should be with the FCM. If your case is a Monday/Tuesday case, you will be interviewed on Day 1 of the review week. On Day 2, the interviews for the first case will continue. After all interviews have been completed, the reviewers will identify preliminary scores for the case, and then debrief with the FCM and supervisor. Following the debrief, the reviewers will attend the Mini‐Round, at which time the preliminary scores may be adjusted based on discussion with other review teams. Day 3 will start the process over again with the Wednesday/Thursday cases. Again, the FCM will be the first interview of the day. If your case is to be reviewed on Wednesday/Thursday, you will be the first interview on Day 3 of the review week. Interviews will continue through Day 4 of the review week. After interviews are completed the review team will identify preliminary scores, and then debrief with the FCM and supervisor. Following the debrief, the reviewers will meet for the Mini‐Round, where they will discuss the case with other review teams and receive input on scoring. On Day 5, a Grand Round will be held. The data from all of the cases will be compiled, trends will be identified, and the data will be presented to DCS staff and community partners at the Grand Round on Friday.


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Slide 10 ‐ Release of Information Title Slide

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Parental consent is a necessary step in beginning the QSR process. The next several slides will provide you with information on contacting and explaining the QSR process to the family.


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Slide 11 ‐ Release of Information 1

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Parental consent is a necessary step in beginning the QSR process, however, family participation in the QSR is voluntary. If the family that was selected for the QSR decides not to participate, another case from the same FCM will be selected. It is important to understand the purpose of the QSR, and to be able to explain it to the families involved in the QSR process. When the family agrees to participate in the QSR, they will need to sign the Authorization to Release Information form.


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Slide 12 ‐ Contacting the Family

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The best person to contact the family is the FCM. It is recommended that the FCM schedule an in‐person visit with the family to explain the QSR process, ask permission to include the family, answer any questions they may have, obtain a signed Authorization to Release Information form, and work with them to develop a list of the most important people involved with the case. It is recommended that any members that have participated in the CFT Meeting process or Case Planning Conferences be among those interviewed.


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Slide 13 ‐ Explaining the QSR Process 1

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When explaining the QSR process, it may be helpful to let the family know that their case was randomly selected, and that their participation will help in providing a review of the services provided to families. Inform the family that the QSR is their opportunity to share their input as to what has been both beneficial, and not beneficial to them during their involvement with the system. Families have the opportunity to share their opinion and experiences, which allows us to make improvements to the system if needed, and learn how to better serve future families.


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Slide 14 ‐ Explaining the QSR Process 2

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When talking with the family, share with them a brief overview of the review week. Let them know that they will be able to talk to reviewers during the review week, and share with them the dates of the review. Allow the family to help you in identifying people they feel are important in their case. Encourage them to include both formal supports, for instance: a therapist, CASA, school teacher, etc., as well as informal supports, for instance: extended family members, significant others in their life, neighbors, or friends. It is recommended that any members that have participated in the CFT Meeting process or Case Planning Conferences be among those interviewed. Reinforce that the information gathered as part of their participation in the QSR will be used to improve the services that we offer to families. Ensure that the family knows that they will not be penalized for saying negative things about DCS, or any system stakeholders. Information is not shared between those parties being interviewed, and ultimately this is a learning opportunity for DCS, and the community partners.


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Slide 15 ‐ Handouts Available for Assistance

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You will receive electronic documents from your QA Lead that will further assist you in preparing yourself, and your families, for the QSR. These include the Authorization to Release Information, Guidance for FCMs for obtaining consent from Parents and Legal Guardians, Family Participation in the QSR, and Review Explanation for Providers and Others.


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Slide 16 ‐ Authorization to Release Information

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The document displayed on your screen is the Authorization to Release Information. This document must be completed on each case that has been selected for the QSR. The parent, legal guardian, or the FCM (if TPR is ordered) must complete this form. Enter the focus child's full name in the space provided at the top of the document. The first line of the document is to be used to print the name of the parent, guardian, or FCM, and to specify the dates that the review will take place. In Section 6, you will enter an expiration date of 90 days after the QSR review week. It is imperative that all signatures be captured at the bottom of the document. Each parent should sign and date above the signature line, and the FCM should serve as witness by signing and dating above the witness signature line. If TPR has been ordered, the FCM may sign in the area where parent signatures are required, with the FCM’s supervisor serving as the witness. If an adoption has been finalized, the new adoptive parents would need to sign and date this form.


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Slide 17 ‐ Release of Information 2

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To review, the following is a list of what is needed to complete the Release of Information form. Beside the space for I/We, print the name of the parent, guardian, or FCM, and specify the dates that the review will take place. In Item 6, enter an expiration date for the release. This should be 90 days after the QSR review week. Each parent should sign and date above the signature line, and the FCM should serve as witness by signing and dating above the witness signature line. Exceptions include the following:

If TPR has been finalized, the FCM may sign in the area where parent signatures are required, with the FCMs supervisor serving as the witness.

If an adoption has been finalized, the new adoptive parents would need to sign and date this form.


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Slide 18 ‐ Case Summary Title Slide

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Now we will look at the steps involved in preparing the Case Summary.


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Slide 19 ‐ Case Summary Description

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The Case Summary is a 1‐2 paragraph overview of the case to be reviewed. The first paragraph should include a summary of why the family is involved with child welfare. You may also include any prior incidents in this paragraph. The second paragraph should include a summary of the past 6 months for the focus child and their family. You may want to include any information that provides the reviewers with updated information about the family.


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Slide 20 ‐ Case Summary Template

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The document displayed on your screen is the Case Summary Template form, and is available electronically from your QA Lead. In addition to writing your case summary descriptions, please make sure to add the focus child’s full name, the FCM’s full name, and the county name, in the spaces provided at the top of the form.


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Slide 21 ‐ Case Schedule Title Slide

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The content covered in this next section will provide you with guidance as you prepare your schedule for the QSR review.


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Slide 22 ‐ Schedule Guidelines 1

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Each case that is selected will be reviewed over a two day time period. Each case will either be reviewed on a Monday/ Tuesday, or a Wednesday/Thursday. Schedules should be completed based on the day that the case is assigned to be reviewed. In order to change review days, the QA Lead must approve, and find another case with which to change. Otherwise, you will not be able to switch the days the case is to be reviewed.


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Slide 23 ‐ Schedule Guidelines 2

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Each face‐to‐face interview should be scheduled for one full hour. Phone interviews, and interviews with young children, generally take less time, and can be scheduled for a 30 minute time frame. Often, phone interviews can be scheduled during the travel time between other interviews. If possible, please ensure that there is time allocated in the schedule for the reviewers to take a lunch. When preparing your schedule for the first day of the review, either a Monday or a Wednesday, please ensure that all interviews are concluded no later than 6 PM. If you must schedule an interview later than 6 PM, please inform the QA Lead. The last interviews, on either Tuesday or Thursday, should be scheduled no later than 11 AM as the reviewers must have adequate time to score the case, and prepare for their debriefing session with you and fellow reviewers later in the day.


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Slide 24 ‐ Who Should Be Interviewed 1

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There are a few interviews that must take place inn person. These include interviews with the focus child (regardless of age), the parent or parents, and the assigned FCM. The only exception to interviewing the parent or parents is if TPR has been ordered. Any informal supports that the family would like to include in the QSR review process are welcomed. This may include step‐parents, or any live in domestic partners, siblings, foster parents, or any other caregivers, such as babysitters, members of the Child and Family Team, extended or kinship family, anyone from the family’s religious community, and friends.


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Slide 25 ‐ Who Should Be Interviewed 2

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Formal supports are also an important part of the interview process. Any of the formal supports you see here are strongly encouraged to take part in the interview process. When including them in the QSR review, be sure to explain the purpose of the QSR, and emphasize how valuable their input is to the process.


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Slide 26 ‐ Monday/Tuesday Blank

Audio Script:

The document displayed on your screen is the template for the Monday/Tuesday Schedule. You will enter the full name of the focus child and FCM in the designated area at the top of the schedule. The area in gray provides you with guidance as to who is required to be included in the interview as well as suggestions for additional interviewees which can consist of both formal, and informal supports. The schedule for Monday will begin at 8 AM, with the reviewers meeting at a designated area for their reviewer orientation. Following the orientation, the reviewers will need time to review the case binders which you have prepared. Once the reviewers have looked over the binders, they will begin with their interviews. If travel time to the location of the first interview is necessary, please allow for the appropriate amount of time. Areas in this template that are highlighted in red are areas that are considered non‐negotiable. Areas in green may be altered to fit the individual case. For example, the interview with the FCM must be the first interview. However, the time may be altered based upon how long it will take for the reviewer to leave the orientation site, and arrive at your location.


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Slide 27 ‐ Monday/Tuesday Completed

Audio Script:

This is an example of what a completed Monday/Tuesday review schedule should look like. The areas in red are considered non‐negotiable, while areas in green may be altered to fit the individual case. The first interview will be with you, the FCM assigned to this case. Subsequent interviews will be scheduled up until 6 PM. If an interview must be scheduled later than 6 PM, please advise your QA Lead, who will notify the PQI Lead for this review. Tuesday’s schedule is available for interviews in the morning, however, it is imperative that the last scheduled interview on Tuesday begin no later than 11 AM, as the reviewers will need time to score their case, and prepare for their debrief sessions with you, your supervisor, and their review peers. In the Interviewee Name and Relationship section, please be sure to provide the full name of the person to be interviewed, and their relationship to the child. In the area marked Phone Number/Address, you will provide the address for the location where the interview will be conducted. You will also provide contact information for that interviewee, so that if a reviewer becomes lost or needs to renegotiate a scheduled time, they may contact that interviewee directly. The final section allows you to indicate whether an interview will take place by phone, or face‐to‐face. Please make sure to allow for the appropriate amount of travel between interviews.


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Slide 28 ‐ Wednesday/Thursday Blank

Audio Script:

If you have a case selected to be reviewed on Wednesday/Thursday, you will follow the same format as the Monday/Tuesday schedule, however, there is no Reviewer Orientation on Wednesday. Instead, reviewers will begin by reviewing the case binder. The times marked in red are non‐negotiable items, and anything shown in green may be adjusted to best fit the schedule.


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Slide 29 ‐ Wednesday/Thursday Completed

Audio Script:

This is an example of what a completed Wednesday/Thursday schedule would look like. Please remember that areas marked in red are non‐negotiable, and any thing in green may be adjusted based on what works best for the schedule. Also, don't forget to allow for adequate travel time.


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Slide 30 ‐ Binders Title Slide

Audio Script:

The next section will focus on the preparation of the binders.


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Slide 31 ‐ Binders 1

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You will need to prepare 2 identical binders for each case that is selected. You will be provided the necessary binders and tabs by the QA Lead. The QA Lead will establish a deadline for the completed binders, and will make arrangements to pick them up once they are completed. The next several slides will walk you through what is to be included in each of the 14 sections for the Binders.


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Audio Script:

Section 1 will include the finalized case schedule. Please ensure that the most current version of the schedule is included in the binders. If any changes are made after the binders are submitted, please clearly communicate the change, and bring copies of the updated schedule with you to the FCM interview.

In Section 2, you will provide the necessary directions to each interview location. Please make sure that directions are from point A to point B, from point B to point C, and so on. If you choose to use Rand McNally or MapQuest, ensure that the directions are correct, and add any landmarks that may be helpful in ensuring that the reviewers reach their destination.


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Audio Script:

Section 3 will contain the completed Authorization to Release Information. You must ensure that the original is included in one of the binders. The other binder should include a copy of the original release form.

In Section 4, you will include the General Information form. This form is set up as a template in a Word document. You may complete this template, and print off two copies, one for each binder. Please make sure to fill out each area completely. If there is a section that does not apply to your case, then mark it with an N/A, so that reviewers will know that this section is not applicable. The last section of the general information form asks questions regarding your history with DCS. This information is collected in order to identify statewide trends.


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Audio Script:

Section 5 should include the brief case summary that was mentioned previously. This summary is essential in providing the reviewers with important case information. A copy of this document should be included in each binder.

In Section 6, you will include all 310s, and 311s that have been created regarding this family. This would include the current 310 and 311, as well as any previous reports and substantiations.

Section 7 is where the Preliminary Inquiry will be placed in the binder. If the case being reviewed is an Informal Adjustment, then include a copy of the signed Informal Adjustment.


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Audio Script:

Section 8 will include the Family Network Diagram. If a Family Network Diagram has not been completed for this family, then you will need to work with the family to complete one prior to the review. Due to the complexity of the family dynamics in some cases being reviewed, it is recommended that a written description be provided to further explain those dynamics for the reviewers.

Section 9 will contain the Safety, Risks, and Needs Assessment. Be sure to include the most recent version.

Section 10 will include information regarding Case Plans, and Child and Family Team Meeting notes. Include a copy of the most recent case plan, as well as any others completed in the last 6 months. Any CFTM notes from the past 6 months should also be included in Section 10.


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Audio Script:

Section 11 should include Contact Notes from the past 6 months, which can be printed off from ICWIS. If there are any significant updates or changes in the case after your binder is submitted to your QA Lead, please bring a copy of those notes with you to your initial interview to provide to the reviewers.

Section 12 will contain any Court Reports related to the case. It is important to include the orders for the most recent court hearings, any court orders regarding a CHINS petition, and TPR in this section. If a case is moving toward adoption, any adoption petitions and/or court orders should be included in this section as well.


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Audio Script:

Section 13 should include any type of assessment that has been completed on the child and or parent. Specifically, any psychological assessment, parenting assessment, medical assessments, First Step evaluations, etc. If a parent or child has had multiple assessments, please ensure that the most recent report is included. If a child has an Individualized Education Plan, or IEP, then be sure to include a copy of that as well.

Section 14 will include copies of the confirmation letters that will be sent to all interviewees 3 weeks prior to their review. An electronic template of this form is available from your QA Lead. The FCM should enter the date, time, and location of the interview, and should also include their name and contact information on this form. It is also recommended that FCMs follow up with a phone call 1 week prior to the review to confirm the appointments with all interviewees on the schedule.


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Slide 38 ‐ Available Forms Title Slide

Audio Script:

The following slide will address the electronic forms that are available to you as you prepare for the QSR.


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Slide 39 ‐ Available Electronic Documents

Audio Script: There are a number of electronic documents available from your QA Lead to assist you when preparing for the QSR. These include:

The Checklist for the QSR Review Folders, which allows you to track the necessary documents required for the QSR binders, and ensure that they are completed in a timely manner.

As mentioned earlier, the cases are assigned specifically to be reviewed on either Monday/Tuesday OR Wednesday/Thursday. There are template documents available for both, but you will want to ensure that you are using the correct schedule document based on which days your case is scheduled for review. Any changes to the scheduled date must be approved by the QA Lead.

The completed Authorization to Release Information form must be included in both binders. Please ensure that one of these documents is an original.

The FCM Guidance for Obtaining Consents from Parents and Legal Guardians form may assist you in talking with the selected families about the QSR process.

The Family Participation in QSR is a form that you may provide to the family if they agree to participate in the QSR, as it shares additional information about the QSR process.

The QSR Explanation for Providers can be used to talk with providers about their role in the QSR.

The General Information Form template is available electronically in a Word document. You may type the information requested into this document, and then print copies for the binders.

The QSR Case Summary Template will provide you with a foundation, and some guidance in preparing your case summary.

The Interview Confirmation Letter template for families can be used to create the interview confirmation letters that you will send to all family members approximately three weeks prior to the review.

The Interview Confirmation Letter template for providers is geared more for professionals working with the family. As with family members, these letters should be sent out 3 weeks before the review.


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Slide 40 ‐ Important Information Title Slide

Audio Script:

The following slide will list some of the important steps, and dates to remember as you prepare for the QSR.


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Slide 41 ‐ Important Items to Remember

Audio Script: Some important items to keep in mind as you begin preparation for the QSR include:

Your scheduled meeting with the family to review and explain the QSR process, and obtain the signed Authorization to Release Information form

Preparation of your 1‐2 paragraph Case Summary, and

Preparation of your preliminary Case Schedule Other Important things to keep in mind as you go through the process are:

The date of your phone interview

The date that the finalized Case Schedule is due, and

The due date for the binders


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Slide 42 ‐ Thank You

Audio Script:

Thank you for participating in your region’s QSR. If you have any additional questions, please contact your QA Lead, or the PQI Leads assigned to your review.

Slide 1 Welcome - Indiana Child Welfare Education and...

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