FOCUS AREA III



FOCUS AREA III

Strengthening Child Welfare Supervision

as a Key Practice Change Strategy

UNIT 2

Preparing to Redesign Child Welfare Supervision

Rationale

For child welfare agencies to achieve outcomes, supervisors must play an active role as practice change agents. As the link between administration and frontline staff, supervisors can use their knowledge and understanding of agency data to provide clinical supervision and proactively direct the achievement of agency outcomes. To develop and implement strategies to effect these changes, designated members of a planning structure need to experience what the practice changes might look like and learn the steps of strategic planning.

Audience

Participants will include individuals identified by leadership in Unit 1, which may include:

• A representative from the agency’s leadership team, to give and explain the leadership’s charge

• Representative supervisors

• Other top managers

• Representative field managers

• Child and Family Services Review (CFSR) coordinator

• Training manager and training partners

• Information technology staff

• Selected community stakeholders

• Court personnel

Expected Outcomes

Participants will:

• Explain the importance of supervisors in the practice change process.

• Describe leadership’s vision of the supervisor’s role and responsibilities in achieving the agency’s mission.

• Carry out leadership’s charge to the planning structure.

• Generate strategies to improve supervisors’ use and understanding of agency, unit, and worker data.

• Generate strategies to improve supervisor’s use of clinical supervision aimed at the achievement of safety, permanency, and well-being.

• Generate strategies to help supervisors motivate staff to change practice.

• Implement the steps of the strategic planning process.

Synopsis

Results from unit 1: Helping child welfare leaders re-conceptualize supervision

Supervisors as Practice Change Agents

• Introduce a new role for supervisors—as practice change agents who provide clinical supervision that proactively directs the achievement of the outcomes that agency leaders have established and defined.

• Define change as deliberate, planned, ongoing practice modifications that result in improved outcomes defined by leadership.

• Describe practice change agent as someone who leads change, rather than merely manages it.

• Discuss why supervisors are well positioned to be effective in this role:

o Link administrators with frontline worker

o Provide highly visible role models for workers

o Provide clinical direction that guides workers

• Discuss other players and roles in the change process:

o Agency leaders and stakeholders define the mission, vision, values, and desired outcomes for the agency

o Supervisors then lead the change in practice to achieve those outcomes

o Frontline staff implement the practice changes in a supportive team with supervisors and coworkers

A New Vision for Supervision

• Explain the new vision for supervision, as defined by agency leaders:

o The value and importance of supervisors to the agency’s mission

o Leadership’s vision of the supervisor’s new role and responsibilities in achieving the mission

o New practice change agent roles that will be added or revised

▪ Use of data

▪ Clinical supervision

o Current roles that will be revised

o Current roles that will be removed

Charge for Planning Structure

• Describe the charge to the group, as defined by agency leaders:

o Role

o Duration

o Plan to communicate with leaders

o Supports from leaders

• Discuss reactions to the new vision.

Use of data: Supervisor involvement in the Child and Family Services Review (CFSR) and Program Improvement Plan (PIP)

Overview

• Discuss purpose and process of CFSRs.

• Discuss three primary ways supervisors can take an active role in the CFSR and PIP:

o Participate in Statewide Assessments

o Participate in Onsite Reviews

o Participate in PIP development, implementation, monitoring and evaluation

Participate in CFSR Statewide Assessments

• Review Statewide Assessment Instrument.

• Exercise: Participants review portions of the previous Statewide Assessment (both the data profiles and the narrative assessments) and consider how the answers might be different in the next round.

Participate in CFSR Onsite Reviews

• Review Onsite Review Instrument.

• Exercise: Participants complete a portion of the review instrument on a selected agency case.

Participate in PIP development, implementation, monitoring and evaluation

• Discuss state’s most recent CFSR results.

• Exercise: Participants interpret select agency reports summarizing CFSR-related data for which agency leaders have concern.

• Review PIP requirements and suggested strategies for development.

• Discuss how supervisors were involved in the last PIP and how they could be involved in future PIPs.

Use of data: Supervisor involvement in quality assurance (QA) or continuous quality improvement (CQI)

Overview

• Introduce the definition and practice of QA/CQI.

• Discuss three primary ways supervisors can take an active role in QA/CQI:

o Serve as a reviewer

o Interpret results of reviews

o Review cases during supervision

o Receive performance feedback

Serve as a Reviewer

• Exercise: Participants rate a case using a section of the agency’s QA/CQI tool.

Interpret Results of Reviews

• Explain the critical steps of data interpretation and analysis:

o Initial identification—how are we performing?

o Questions to consider when examining data

o Exercise: Examine data tables and answer key questions about the data

o Postulating and hypothesizing—what might explain this performance?

o Factors to consider when developing hypotheses to explain performance

o Exercise: Identify factors to consider when explaining differences in performance in a case scenario

o Testing and findings—of these factors, what can be verified?

o Three main information sources a supervisor can use to verify or reject hypotheses

o Comparing subgroups to verify the influence of an identified factor

o A template to facilitate the development of hypotheses

o Exercise: Develop hypotheses about sample data tables

o Importance of considering alternative explanations

o Drawing conclusions—what can we conclude from these data?

o Confirming correlations without assuming causation

• Exercise: Apply the steps of data interpretation and analysis to a case example.

Review Cases During Supervision

• Discuss how a state or agency can create a CFSR-based case review tool that supervisors can use as part of case supervision.

Receive Performance Feedback

• Discuss the qualities of good management reports: RESULTS

o Relevant: aggregated by unit and up to date

o Easy: simple to read, show trends, indicate percentages, and allow for comparisons

o Stresses Outcomes: designed to emphasize outcomes, show progress

o Utility: designed to enable managers to identify cases and drill down for further analysis

o Lean: minimal reports; necessary summaries and calculations included

o Trustworthy: accurate and verifiable

o Standards: display standards or expected levels of performance and extent to which they have been met

• Exercise: Participants use a written survey to evaluate the quality of the agency’s existing management reports and discuss which reports are most helpful, which need modification, and what reports could be developed.

Supervisors as practice change agents: Clinical supervision

• Discuss questions that might be addressed when evaluating existing clinical supervision expectations and establishing new expectations:

o Who will participate in the case consultation or review with supervisors?

o At what level will data be reviewed?

o How will the data be gathered?

o What type of data will be reviewed?

o What decisions and plans should be made as a result of review and consultation?

o What should be documented during or after the consultation/review, where should it be documented, and by whom?

o When will consultation occur?

o How will consultation take place?

• Review clinical supervision expectations in another state.

• Discuss a structured approach a supervisor might use for an initial clinical case conference.

Using data and supervision to change practice

• Discuss how supervisors can combine their knowledge of data and best practice to implement changes that improve outcomes:

o Target individual cases: identify specific cases on which to take action (clinical supervision)

o Modify agency systems: seek to change or influence changes in agency administrative systems

o Create key actor collaborations: seek input, create collaborations, or influence systems that impact the agency’s ability to achieve outcomes

o Develop staff capacity: build skills and knowledge that enable staff to achieve outcomes regardless of function

o Secure resources: obtain appropriate resources (e.g. staff, financial) to better achieve outcomes

o Reward others: reward and motivate staff and key actors when they achieve optimal outcome levels or do things that are likely to achieve outcomes

o Obtain more information: gather or obtain more information to inform program improvement action as needed

• Exercise: Participants select a CFSR outcome and generate possible supervisory actions or directions to improve the outcome.

• Exercise: Participants read scenarios and develop plans for using data to change practice.

Motivating staff to change practice

• Explain why people are often resistant to change.

• Explain what supervisors can do to build commitment among workers:

o Ensure effective communication

o Serve as a role model and lead by example

o Involve workers and reinforce their roles in achieving outcomes

o Remove barriers and provide supports that allow staff to implement the desired changes

o Recognize and reward successful change, without undermining momentum

• Exercise: Participants a) identify a practice change they implemented that required acceptance and commitment from staff; and b) evaluate the effectiveness of the change in light of the previous discussion and explore what, if anything, could have been done to enhance the success.

The strategic planning process

• Explain the four primary steps of strategic planning:

o Preparation

o mission

o vision

o guiding principles, values, and beliefs

o Development

o assess the current reality of the agency

o prioritize needs, strengths, and resources

o define what needs to be accomplished, what will be done to get there, how to measure progress, who will be responsible, and what the timeframes are for completion

o Implementation

o Revision

Next steps and work plan

• Exercise: Participants collectively develop a work plan that includes how many meetings will be necessary, the dates of those meetings, and what will be done at each meeting.

[03/02/07]

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