Continuous Quality Improvement

in Georgia

Arvine Brown, Sharise Thurman, and Deborah Price

Department of Human Services Division of Aging Services

What is Quality Assurance?

Quality assurance, or QA for short, refers

to a method for the systematic monitoring

and evaluation of the various aspects of a

project, service, or facility to ensure that

standards of quality are being met.

How Do You Do That?

DAS uses the never-ending

quest of Continuous

Quality Improvement (CQI)

for improving all aspects

of performance through small

incremental steps as

well as through targeted

breakthroughs.

DO

ACT

PLAN

CHECK

PDCA Cycle

Great, How Do You Do CQI?

• 4 Step Approach:

• Customer Focus– We must understand who they are, what they need and then satisfy their needs.

• Data Driven Decision Making– Focus on processes, data that measures the processes and performance, and then use that

information to make improvements.

• Use Teams to Solve Problems– Include everyone because all work is part of a process and teams must be empowered to

improve them.

• Integrate Planning– Learn from the past, work together to shape the future, identify and remove barriers to

success.

Why Do This in Government?

Meet or exceed customer expectations

Become more competitive

Use successes (and sometimes failures) as advocacy tools

Demonstrate ROI (Return on Investment) for decision makers

GEORGIA DCSS RECEIVES 2010 MOST

IMPROVED PROGRAM AWARD

Congratulations to the Division of Child Support Services (DCSS) for

being named as a recipient of the 2010 Most Improved Program Award.

This award is based on a 3-year review and given by the National Child

Support Enforcement Association (NCSEA). It recognizes any program

throughout the nation that has shown exceptional improvement in child

support performance. DCSS is leading the way in superior performance;

and we are pleased to call them one of our own. They will be honored

with this award at the NCSEA Annual Conference in Chicago this

August.

GEORGIA DFCS RANKED 7TH IN US – FOOD

STAMP ACCURACY

• The Department of Family and Children’s Services (DFCS) will receive a performance award of over $4 million from the Food and Nutrition Service (FNS). This award is in recognition of outstanding performance in the issuance of Food Stamp benefits. Last year, DFCS distributed nearly $2 billion in food stamp benefits, giving them a payment accuracy rate of 97%. This accuracy rate is now ranked 7th in the country.

Ranking of States by Rates of Food Insecurity among Senior

Americans 2001-2007 – Order from Highest to Lowest

State Rank Rate State Rank Rate

Mississippi 1 12.29 Kansas 27 5.03

South Carolina 2 9.83 New York 28 5.03

Arkansas 3 9.7 Oregon 29 5.01

Texas 4 8.9 Alaska 30 4.96

New Mexico 5 8.82 Washington 31 4.83

Georgia 6 8.58 Montana 32 4.79

Alabama 7 7.39 West Virginia 33 4.71

Louisiana 8 7.36 Utah 34 4.65

North Carolina 9 7.3 New Jersey 35 4.64

Oklahoma 10 7.12 Vermont 36 4.52

Arizona 11 6.41 Nevada 37 4.36

Indiana 12 6 Pennsylvania 38 4.31

Missouri 13 5.88 Massachusetts 39 4.29

Maryland 14 5.76 Colorado 40 4.15

Idaho 15 5.69 Iowa 41 3.95

Tennessee 16 5.62 South Dakota 42 3.9

Maine 17 5.46 Wyoming 43 3.9

California 18 5.44 Illinois 44 3.88

Rhode Island 19 5.41 Delaware 45 3.76

Kentucky 20 5.4 Connecticut 46 3.64

District of

Columbia 21 5.37 Wisconsin 47 3.6

Virginia 22 5.27 Nebraska 48 3.32

Hawaii 23 5.24 Minnesota 49 3.08

Florida 24 5.14 New Hampshire 50 3.01

Michigan 25 5.09 North Dakota 51 1.53

Ohio 26 5.06

Regional Benchmarking Work Group

• The purpose of this work group is to develop standardized performance indicators that can be used to demonstrate program benefits and outcomes. Creating a more consistent method of accountability and accessing meaningful evaluative data can better position State Units on Aging (SUAs) to advocate in their own states and at the federal level to continue or enhance funding for services that have proven benefit for consumers.

• Consists of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee

• Looks beyond NAPIS data for comparisons

Regional Benchmarking Work

Group Comparative Measures

Fiscal Accountability - Percent of State/Federal Funds Expended by SUA

Ombudsman Responsiveness - Percent of complaints resolved to resident’s satisfaction

Home Delivered Meals - Percentage of Clients Improving High Nutritional Risk Scores

ADRC Consumer Safety and Protection - Crisis call follow up within 14 days

“Good is no longer good enough!”

Good, better, best.

Never let it rest,

Till your good is better,

And your better is best!

St. Jerome

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

ADLI•A = Approach – Refers to systematic methods used,

appropriateness, and effectiveness of these methods

– How do we do what we do?

•D = Deployment – Approach is deployed in depth and breadth

to appropriate work units

» Is everyone knowledgeable of our approach to a

process?

• L = Learning – Refers to new knowledge/skills acquired

through systematic research, evaluation/improvement cycles,

input from stakeholders, benchmarking

•“Integration” refers to the extent to which your measures,

information, and improvement systems are complementary across

processes and work units

DAS Plan Alignment

Area Plan DAS Hoshin DHSState PlanAOA

5. Management Effectiveness (HR, Financial,

Technology, Evaluation)

1. Access (Information, Program, Collaboration)

2. Wellness (Information, Program, Collaboration)

3. Caregiver Support (Information, Program,

Collaboration)

4. Elder Rights/ Protection (Information, Program,

Collaboration)

Increase

Healthy Pro-

social Behavior

Improve Use of

Technology

Employee

Engagement

Increase

Employment &

Self-

Sufficiency

Increase

HCBS

Employee

-Professional

Development

-Satisfaction

-Recruit/Retain

-Succession

Planning

Financial

-Resource

Development

-Accountability

Process

-Efficient/

Effective

-Optimize

Technology

-Internal

Communications

Customer/

Client

-Access

-Marketing

-Prevention

-Advocacy

Wildly

Important

Goal (WIG)

Prioritization Matrix -2010

Impact on all

Customers

Need to

Improve

Aligned

to

Vision TOTAL

O – Elder Justice Act 4 3 3 M

O – Healthcare Reform 4 4 4 M

T – Loss of DAS State Funding (Policy Waiver increases Risk) 5 5 4 100

O – Placement resources/processes for vulnerable adults (Housing) 4 5 4 80

W – Limited Resources 5 5 3 75

W – Internal IT funding and support (we don’t get Gaits) 5 5 3 75

W _ Partnership with AAAs is strained 4 4 4 64

W – Lack of bilingual staff (cultural competency) 4 4 4 64

O – Funding/ Grant Opportunities/ Develop Internal Process for Grant

Development 4 4 4 64

W/O – Transportation/ mobility (Innovative approaches) 4 4 4 64

T – Growth in APS target population 4 4 4 64

O – External collaborators (Law enforcement) 4 4 4 64

T – Loss of DAS Programs 4 4 4 64

T – Limited funding for Community-based programs (Institutional bias for

NF) 4 4 4 64

O – Streamline measures and action plans 4 5 3 60

W – Staff overworked (stress) 3 4 4 48

W – Aging not priority in DHS/ they don’t understand us 3 4 4 48

W – Knowledge transfer/ cross training/ succession planning 4 4 3 48

SCALE: 1= None 2=Low 3= Moderate 4=High 5=Extreme M=Mandate

O – Marketing of Division 4 4 3 48

O – HB 850 levels of care for Assisted Living 3 4 4 48

O – AIMS Redesign (Data mining) 4 4 3 48

O – Cooperative Community-based approach to Aging in Place 4 4 3 48

O – Website development 5 3 3 45

W – Partners now in other Departments 4 3 3 36

O – Timely Communications (External) 3 4 3 36

W – Inconsistent revision/ deployment/ implementation of policies/

standards/ processes 3 4 3 36

O – Foster internal partnerships 4 3 3 36

O – Timely Communications (Internal) 3 3 3 27

O – Project 2020 3 3 3 27

O – AAAs should be Gateway with ADRC 3 3 3 27

O – Coordination of training events 3 3 3 27

W – Training on QI Tools (JIT) 3 3 3 27

O – Leverage expertise in innovative ways 3 3 3 27

W – Limited External Training 3 3 2 18

SCALE: 1= None 2=Low 3= Moderate 4=High 5=Extreme M=Mandate

1717

Strategic Objectives – 2011 – 2015

DAS Strategic Objectives

Scorecard

Perspectiv

e Objective Champion Measure

Targets

2011 2015

1.0

Customer/

Client

1.1 Expand Community

Living Strategies Jamie Plan developed by 9/30/2010

1.2 Improve Marketing J

Marketing Plan by 6/30/2010

Measures related to DAS brand, Service Branding, Providing

Information

1.3 Improve Protection

of Vulnerable

Adults

Shirley/

Barbara

1.31 % APS cases timely investigated within 10 calendar days

1.32. % of APS cases investigation completed w/in 30 business days

1.33 Client Fall Rate (HCBS)

% APS clients going into long-term care

2.0

Financial

2.1 Develop/expand

Funding Streams

Blake/Jamie

/

Arvine/

Jeni

Develop Internal Process for Grant Development

2.11 Competitive Grant Funding Received ($)

2.12 Funding Leveraged through Partnerships ($)

2.13 % Budget from Non-traditional sources

2.2 Increase funding for

technology

development Blake 2.21 Infrastructure Budget Attained ($)

1818

Strategic Objectives – 2011 – 2015

DAS Strategic Objectives

Scorecard

Perspectiv

e Objective Champion Measure

Targets

2011 2015

3.0

Employee

3.1 Increase Employee

Engagement Becky/ Allan 3.11 % Employee Engagement (Gallup12)

3.2 Improve Internal

Knowledge

Sharing Arvine/ Jean 3.21 % Employees with access to SharePoint

4.0

Internal

Process

4.1 Improve Internal

Communication Barbara

4.11 % Employees Satisfied with Internal Communications

Project to get employees to understand various communications

channels

4.2 Improve AAA

Satisfaction with

DAS Services J 4.21 Customer Engagement Index (Gallup)

4.3 Improve/ Prioritize

Internal Processes S & S & D 4.31 % Key Processes Documented

4.4 Streamline/ Improve

Programmatic

Measures “ 4.41 Determine critical measures to report for management level

Prioritization of Internal & External FactorsW

O

T

Issue Impact on

Customer

Need to

Improve

Alignment to

Vision

Total Mandate

t

Budget Crisis- Morale issues due to furloughs, benefits cost increases and travel restrictions. Basic office supplies are depleted. Spending restrictions for equipment replacement and f2f training opportunities -impends work due to travel restrictions 0 M

oContinued growth in target populations

0 M

oDiversity of clients

0 M

o

Partnering with DHS & DCH; provide input into restructuring & influence

0 M

t

Personal economic impact on staff increasing stressors. (rising costs in personal expenditures/gas costs and no cost of living raises). 0 M

t

Uncertain political climate and structural reorganization. (program & staff job security) 0 M

t

Medicaid growth rates outpace the state and national economic growth; strain on Medicare resources (baby-boomers).

0 M

t

Lack of state dollars negatively impacts our ability to match federal/other grants

0 M

tLoss of TCM$

0 M

tRestructure of DHR and DCH

0 M

Prioritization of Internal & External FactorsW

O

T

Issue Impact on

Customer

Need to

Improve

Alignment to

Vision

Total Mandate

w Lack IT support that is readily available. 5 5 5 125

w Marketing/education to community /Web Site 5 5 5 125

w Data still exists in two systems 5 5 5 125

w

Waiting list for services; especially direct services (APS) and HCBS (marketing); response time to be able to meet the demand and need of customers

5 5 5 125

o

LTC demands are shifting away from facility based services to in-home services. 5 5 5 125

o

Consolidation of all programs into AIMS – comprehensive case management 5 5 5 125

w

Lack of communication w/ other sections, contractors, DHR; MG provides good leadership w/ UR2NO 5 4 5 100

w

Multiple responsibilities impedes ability to complete duties in a timely manner 4 5 5 100

o

Managing using data (workforce mgmt. including assignments/coverage). 5 4 5 100

o Efficiencies in service delivery. 5 4 5 100

o

AAAs find a market for private pay for certain services (case management) 4 5 5 100

t

Lack of strong home health provider capacity system including housing, transportation 5 4 5 100

w

Staffing levels (hiring) in some areas around the state are insufficient. Barriers to hiring 4 4 5 80

o External collaboration which leads to innovations 4 4 5 80

Aligning Objectives with SectionsDAS Strategic Objectives - Alignment Matrix - 2010

APS LTCO CCSP LC AtS FA PI DIR

1.1 Increase Access to Quality

Services (Jamie and Shirley) H H H H H H M M1.2 Improve Marketing (Maria &

Jeni) M H M L H M M M1.3 Expand Prevention

Initiatives (Shirley and Mary H L H L L L L H

1.4 Advocacy (Becky)L H M L M M L M

2.0 Financial 2.2 Accountability (Blake)M M M L M H M M

3.2 Satisfaction (Arvine)M M M M M M H M

3.3 Recruitment/ Retention

(Jean) M L M L L M L M3.4 Succession Planning (Mary

Martha) H L M L M M M M4.3 Improve Internal

Communications(Doris, Arvine) M L M M M M H M4.4 Enhance Technology -

Fiscal Accountability WIG M L H L M H H HAlignment H- High, M-Medium, L-Low

Rev. 2/10

4.0 Internal

Processes

1.0

Customer/Clie

nt

3.0 Workforce

Sections

Scorecard Division Objective

Strategic Challenges & Advantages

Category 1 - Leadership

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

Mission Statement

DAS, together with the Aging Network and

other partners, assists older individuals,

at-risk adults, persons with disabilities,

their families and caregivers to achieve

safe, healthy, independent and self reliant

lives

Vision Statement

Living Longer, Living Safely, Living Well

2727

Review Mission, Vision, Values

• Lets Review & Discuss Our Values:

Value: Definition:

A Strong Customer Focus We are driven by customer, not organizational, need…

Accountability and Results Good stewards of the trust and resources …

Teamwork Teamwork is the way we do business...

Partnership Value partners and actively pursue new partnerships…

Open Communication Communication is the lifeblood of organizations…

A Proactive Approach Anticipate the needs of our customers and advocate …

Dignity and Respect We respect the rights and self worth of all people...

Our Workforce Workforce, including volunteers, are our best assets…

Trust Honest with one another and with our customers…

Diversity Value diverse workforce, it broadens perspective…

Empowerment We believe in self-determination for our customers…

Positive Work Environment Division maintains a learning environment with

opportunities to increase professional growth…

Category 2 – Strategic Planning

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

Hoshin HistoryFirst HOSHIN Planning Session January 1998

GOAL: Manage the Organization Using Data

Sub-Objectives:

1. Data are available (Resulted in AIMS Database)

2. Data are used (Key success factors,

measurements have been adopted)

Lesson Learned: Since plans are dynamic an

audit/review process must be used

Second Hoshin - 2006

Second HOSHIN Planning Session January 2006

Developed Second Hoshin Statement: By the year

2011, Georgia will have the highest performing aging

network in the US that champions consumers living

safer, healthier, more self reliant lives.

Strategic Focus Areas: Via Balanced Scorecard

Format

1. Customer/Client

2. Financial

3. Employee

4. Internal Process

Lesson Learned: How will we know it when we see

it?

Strategic Planning Process (Hoshin Planning)

Staff StakeholdersSenior Leaders

NEED PLAN

1. Review Mission,

Vision, Values

2. Review Existing

Plans, Reviews, Audits

3. Review/Understand Customer/Partner Requirements

4. Perform Internal and External SWOT

5. Determine Strategic Objectives/Targets/

Timelines

Assign Champions

6. Align Objectives with Sections

7. Develop Section Objectives and Action

Plans

8. Align with Budgets

9. Review Plans and Progress

10. Evaluate and Improve Process

Plan

Developed

DAS SPP

HOSHIN – every 4 years

State Plan – every 4 years

Annual Baldrige assessment

Annual review of MVV

SWOT/Environmental Scan – every 1 to 2 years

Dashboard/Balanced Scorecard – update quarterly; review and revise

semiannually

Section Action Plans – update and review quarterly

PDCA system

MAP measures – Update & review quarterly; LT reviews quarterly and

annually to review trends

Customer Requirements – Annual Area Plan Cycle

LT reviews monitoring and evaluation reports as they are conducted;

review of Public Hearings comments; C3 process;

Key Processes – Review and update annually as of SFY09

Focus

AreaStrategic Objectives Measure

Current Year

Goals/Measures

2008-09

3 Year Projection

(2011)Selected Current Year Action Plans

1.0

Custo

mer/

Client

1.1 Increase the #/%

of high risk customers

in HCBS and CCSP

1.11 DON-R impairment level of 15 and 1

unmet need (HCBS)

75% 80% each year

(2010 & 2011)

1.11 Increase the #/% of high risk customers

(non Medicaid eligible) in Home and Community Based

Services (HCBS)

1.12 DON-R impairment level of 15 and 1

unmet need; plus composite score of 23

or higher(CCSP)

New Measure

SFY09

TBD based on initial

result

1.12 Increase the #/% of high risk customers

(Medicaid eligible) in Community Care Services Program

(CCSP)

1.2 Improve

Marketing

1.21. # ADRC information & assistance

served;

1.22. ADRC web visits

1.23. LTCO web visits

1.24. DAS web visits

1.25. DAS 1-800# calls received

1.26. Live Well Age Well web visits

1.21 - 55,516

1.22 – New

Measure

1.23 – 60,042

1.24 - 7116

1.25 - 2,254

1.26 – 41,803

1.21 – Increase 5%

annually

1.22 – New Measure

1.23 – 64,000

(2010 & 2011)

1.24 – Increase 3%

per year

1.25 - New

Measure

1.26 – Increase

5,000 visits per year

1.21. Increase # of customers accessing Aging and Disability

Resource Connection (ADRC) for information and assistance

1.22. Increase ADRC web visits

1.23. Increase LTCO web visits

1.24. Increase DAS web visits

1.25. Increase DAS 1-800# calls received

1.26. Increase Live Well Age Well web visits

1.3 Expand

Prevention Initiatives

(WIG measures)

1.31 % APS cases timely investigated

within 10 calendar days

1.32. % of APS cases investigation

completed w/in 30 business days

1.31. 93.6%

1.32. 80.7%

1.31 95% each year

1.32 85% each year

1.31 & 1.32 Reduce APS investigations not completed timely

within guidelines as defined by policy by June 30, 2009.

1.33 % Safety protocols developed

1.34 Recidivism Rate

1.33 – See Safety

Team Report

1.34 – 5.67%

1.33 – TBD

1.34 < 1%

1.33 Increase APS safety protocols that prevent serious injury

or unexpected death of APS staff.

1.34 Reduce APS Recidivism Rate

1.35 % of CCSP clients contacted timely

1.36 Decrease rate of falls resulting in

fractures

1.35 100%

1.36 12 counts of

fall incidents

1.35 100%

1.36 Reduce by

20% (2010 & 2011)

1.35 Achieve 100% of CCSP clients contacted in a timely

manner by Case Management.

1.36 Decrease falls resulting in fractures by 20% in 2009

1.4 Improve

Advocacy

1.41 % of desired Legislation

Amended/ Passed

1.41 3.5% SFY08 1.41 3% increase in

legislation passed

per year

1.41 Increase % of legislation amended / passed at the state &

federal level

2.0

Financi

al

2.1 Reduce Lapse 2.11 DAS100% expended each fiscal

year; AAA 95% expended within 5% + / -

of program guidelines

2.11 -DAS 99.79%

AAA’s – Available

onsite

2.11 DAS -99%

expenditure per

year; AAA – 95%

with a goal of 100%

expenditure

2.11Reduce Budget Lapse by AAAs & DAS

Focus AreaStrategic

ObjectivesMeasure

Current Year

Goals/M

easures

2008-09

3 Year

Projectio

n (2011)

Selected Current Year Action Plans

3.0 Employee

3.1 Increase

Employee

Satisfaction

3.11 % satisfied with job and overall

atmosphere

3.11 - 85% 3.11 2010/11-90% 3.11 Increase employee satisfaction with job and overall

atmosphere with DAS

3.2 Increase

Employee

Satisfaction

with

Compensati

on

3.21 % satisfied with benefits and

compensation

3.21 – 50% 3.21 2010/11-

60%

3.21 Increase employee satisfaction with benefits and

compensation received

3.3 Reduce Hiring

Cycle Time

3.31 # of days to hire employee from

posting of position

3.31 - 62 days 3.31 - 45 days

2010/11

3.31 Decrease number of days to hire an employee from posting

of position

3.4 Reduce

Turnover

Rate

3.41 # of vacated positions/ # of filled

positions x 100

3.41 - < 10% 3.41 - < 20%

2010-11

3.41 Achieve under 20% annually for DAS turnover rate

3.5 Reduce

Turnover

Rate for

First Year

Employees

3.51 # of vacated positions/ # of

budgeted positions x 100

3.51- < 1% 3.51 - < 3%

2010-11

3.51 Maintain the DAS turnover rate for first year employees

under 3%

3.6 Deploy

Succession

Planning

Process

3.61 # of candidates successfully

completing succession

planning program

3.61 Baseline of

4

candidat

es

3.61 –

2010 – 5

2011 - 6

3.61 Achieve the number of succession planning candidates

annually who complete the program every 12 months

4.0 Internal

Process

4.1 Improve

Internal

Communica

tion

4.11 % Employees Satisfied with

Internal Communications

4.11 - 84% 4.11 –

2010 – 90%

2011 – 95%

4.11 Increase DAS employee satisfaction with internal

communication processes

4.2 Improve

Technology

– Fiscal

Accountabil

ity (WIG)

4.21 New Measure being developed 4.21 Baseline for

SFY09

4.21 - TBD 4.12 Integrate CHAT into AIMS database

Section Name:

CCSP

Section Objective: 2.2

Maintain and increase

financial accountability

for CCSP

Action Plan for:

Accountability

Resources Needed: Staff

Hours Each

Track On-

going

Referral

Time

To be Completed by: $: Labor

Hours:

Document Source: J:\CQI\Hoshin

Success to be

Measured by:

100% of CC

funds

are

expend

ed.

Specific Actions By Whom When How Accomplished Update

1. Care

Coordination

review of

expenditures

JS, CC

Speciali

sts;

SPM &

DAS

Admin

Qtrly

Ongoing

Initiate qtrly review of AAA CC

dollars expended;

formalize process that

contact or notification

from the Specialist

and/or Section Manager

speaks with the AAA if $

are being lapsed in the

2nd qtr (variance of 5%).

Annual review of

allocation during each

new budget process.

9-21-06 - Current monitoring process

- State CC specialists speaks

with AAA if 25% of $ has not

been expended in Q1. Process

Improvement - Section Mgr

provides a call and letter in Q2 if

expenditures have not met the

50% threshold.

-6-07 Review and approval of

budget variance MAP. SFY

2008 run bew MAP. DONE

Action Plans Continued

2. Monthly

monitoring of

fiscal budget

(4.2 on DAS

Scorecard)

SPM; JR Qtrly

Ongoing

Review MID reports for benefit

expenditure; Compare the

different billing numbers in

terms of what CCSP

spent vs. what OFS

indicates as being spent;

analyze spikes; Work with

Judy Hagebak within

DCH. Compare services

authorized files versus

paid files deauthorized.

Review service authorization and

payment form in AIMS.

Note: providers have a 6

month window to bill which

creates a claim lag in actual

expenditures.

-7/07 Quarterly memo sent

to OFS Jim Sanregret.

Invoice and AIMS reports

closer. Ongoing monthly

review.

Category 3 – Customer & Market

Focus

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

DAS’ Customers

The OAA, other federal laws,

and Georgia state law define

DAS’ customers, clients,

customer groups, and market

segments.

• Our end customers, as defined by these

laws, include senior citizens, other adults

with disabilities and their families,

caregivers, and advocates.

Voice of the Customer

How do we listen to our clients?

• Monitoring and evaluation of partners and suppliers, including during site visits

• Consumer satisfaction surveys for various services

• Focus groups

• Public hearings

• Client data assessment tools such as the Determination of Need-Revised (DON-R)

• Client consent for protective services interventions

• Program wait list data

• Advisory councils and

• Complaint data

Figure 3.1-1 DAS Customer and Market Groups and Voice of the Customer

DAS

SectionsCustomer and Market Products and Services Key VOC Listening Approaches

APS

Elders 65 years of age or older

Disabled persons over the age of 18 years of age

Persons above who are not residents of long

term care facilities (O.C.G.A. 30-5-1)

Investigation

Case Management

Community Education

Training

DHR Guardianship of Wards

Program Management/ Development

Emergency Relocation

Personal Care Home (PCH) Relocation

Consumer Fraud Prevention Program

Case Management

Central Intake 1-800#

Surveys

Future Providers and Partners Survey

C3 Process

DON-R

Advisory Groups

Area Plan Feedback

Customer Complaints

AtS

Elderly Legal Assistance Program (ELAP) - Persons 60

years of age and older needing legal

representation, information, and education in civil

legal matters.

Aging Disability Resource Connection (ADRC) - Older

adults, individuals with disabilities and their

families to a coordinated system of partnering

organizations dedicated to providing accurate

information about publicly and privately financed

long-term supports and services and offering a

consumer-oriented approach to learning about

the availability of services in the home and

community.

GeorgiaCares - Helps Medicare beneficiaries and

others understand their rights, benefits and

services offered under Medicare and Medicaid,

and other health insurance options offered

through public-private partnerships.

Group Community Education

Benefits/Resources Counseling for Medicare

Beneficiaries

Legal Services

Training and Technical Assistance

Senior Medicare Patrol (SMP) Fraud Reporting

Information& Referral to Resources for the elderly

and disabled

Case Consultation

Outreach to the general public

Focus Groups, Public Hearings

ADRC Advisory Group

GeorgiaCares Advisory Group

Area Plan Feedback

Customer Complaints

Professional Affiliations

Surveys

C3 Process

Category 4 – Measurement, Analysis &

Knowledge Management

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

DAS

DASHBOARD

LTCOP ACTION PLAN /

OBJECTIVE

MAP TITLE AND BASELINE RESULT

S FY 09

TARGE

T

FY 09

BY QUARTER

1st Qtr 2nd Qtr 3rd Qtr 4th Qtr

Customer

Organizational

Effectiveness

Response Time within Standard –

Abuse Complaints: Resident at

Risk. Baseline: 100 percent (FY

05)

97 % 98 % 100 % 100 % 100 % 89 %

Response Time within Standard –

Abuse Complaints: Resident Not

at Risk. Baseline: 99 percent (FY

05)

97 % 98 % 100 % 100 % 97 % 89 %

Response Time within Standard –

Other Complaints. Baseline: 98

percent (FY 03)99 % 98 % 99 % 99 % 99 % 97 %

Customer

1.1 – Increase access to quality

services: Increase LTC residents’

access to quality LTCO services

Complaint Resolutions – Positive

Outcomes. Baseline: 94 percent

(FY 03)93 % 97 % 96 % 94 % 97 % 93 %

Customer

1.1 – Increase access to quality

services: Increase LTC residents’

access to quality LTCO services

Routine Visits – Nursing Homes.

Baseline: 65 percent (FY 07)84 % 91 % 93 % 95 % 90 % 96 %

Routine Visits – ICF/MR.

Baseline: 64 percent (FY 07)100 % 91 % 100 % 100 % 100 % 100 %

Routine Visits – Personal Care

Homes. Baseline: 52 percent (FY

07)67 % 80 % 85 % 83 % 83 % 81 %

Routine Visits – Community

Living Arrangements. Baseline:

43 percent (FY 07)78 % 91 %

n/a –

based on

six

months

n/a –

based on

six

months

n/a –

based on

six

months

n/a –

based on

six

months

Customer

1.1a – Increase access to quality

services: Evaluate customer

satisfaction with ombudsman

complaint processing

Customer Satisfaction – Would

Use Again / Recommend.

Baseline: 94 percent (FY 06)

survey to

be

completed

in 2010

96 %survey to be completed and results made

available in 2010

Customer

1.2 – Improve marketing: Increase

the number of people served by

LTCOP

Website Sessions. Baseline:

35,554 sessions (FY 06)[1]

73,941

sessions1

64,000

sessions1

15,952

sessions1

17,826

sessions1

19,676

sessions1

20,487

sessions1

Visits to Website. Baseline:

43,114 visits (FY 06)[2]

unavailabl

e

64,000

visits

16,520

visits

18,703

visits

unavailable –host

changed stats package

SMART Measures

• Specific – Well defined measures that define, Quality, Timeliness, Cost (or Revenue), Safety, Environment

• Measurable – Must be quantifiable and focused on a specific outcome

• Achievable – Moon or Mountain Scenario

• Reportable – Measures item you desire to see impacted

• Time bound – Results should be collected and tracked at regular and frequent intervals.

Category 5 – Workforce Focus

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

80%

10

0%

80%

83

%

78%1

00

%

100%

91

%

64%9

2%

79%

86

%

58%

10

0%

83%

80

%

46%

86

%

93%9

2%

33%

10

0%

67%

0%

30%

69

%

86%

50

%

35

%

80%

68

%

75%

78

%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

LTCO PI LC CCSP AtS COA DIR APS FA

2004 2005 2007 2008

Overall Response Rates

Positive About DAS

69%

65%

56%

68%

64%

69%

77%

53%

47%

59%

55%

64%

67%

72%

69%70%71%

77%75%

71%

80%

74%74%76%

81%

70%70%

71%

75%

78%

45%

55%

65%

75%

85%

Work

Environment

Organization Communication Personal

Satisfaction

Training Leadership

2002 2004 2005 2007 2008

Category 6 – Process Management

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

Core Competencies

• 1. Depth/Breadth of experience in gerontology, social sciences and elder law/justice;

• 2. Engaged in developing and implementing evidence-based models and research;

• 3. Knowledge of national and state long-term care policies, trends and stakeholders;

• 4. Expertise in statewide program planning, development, administration, and evaluation;

• 5. Ability to establish and maintain key partnering relationships to build a statewide advocacy network; and

• 6. Systems design, development and management through the usage of accurate, timely and complete data.

Macro Processes

• Policy and Standards

• Fiscal and Contract Administration

• Public Education and Outreach

• Program Management

• Strategic Planning

Sec

-tion

Products/

Services

Key

Processes

Require-

ments

Mea-

sures

PI State & AAA contract deliverables

State Plan

State Reporting Tool to AoA

Provider performance, consumer

sat, measurement of svc quality &

programmatic standards; review

guides; surveys; monitoring rpts

AIMS – tool for data capture & rpt

Policy, recommendations for best

practice, reporting ed, knowledge

more geared towards safety

DAS annual report (JtF)

Meet goals, target objectives for

Div via Operational/Strategic Plan

Emergency/BC Plan

Area Plan

State Plan

NAPIS

Monitoring and Evaluation

Serious Incidence Review

Team (SIRT)

AIMS Development

Forensic Training

(Outreach targeted to

mandated reporters and 1st

responders)

Regulatory Reports (Just the

Facts (JtF))

Strategic Planning

Account Management Team

(AMT)

Consider RC processes –

1.Project Plan Completion

Information

Program Knowledge

Good Customer Service

Cultural Competence

Reliable/Accurate Data &

Systems

Successful

organizational

improvement initiatives

# of Area Plans

submitted on time

# of State Plans

submitted on time

NAPIS timely

submission

M&E – Timeliness

(date due vs. date

completed)

AIMS reliability - %

system up &

available

Forensic Training -

# of training

conducted police &

coroners

# of JTF completed

on time

SP - # of measures

Meeting &

exceeding targets

1.Work Plan

Effectiveness Measure

2.Success Rate of

project completion

Plan- Do- Check- Act

Plan – Determine what we are trying to accomplish

Determine process requirements, measures, and

evaluation methods.

Where are we now?

Where do we want to be?

What do we need to do to get there?

How do we monitor our progress?

Do – Execute plans.

Check – Assess progress; determine what is working

and what is not working; what process improvements

can be made; what organizational and personal learning

is occurring?

Act – Revise plans based on assessment findings,

learning, new requirements, and opportunities for

innovation.

Category 7 Results

1

Leadership

2

Strategic

Planning

3

Customer and

Market Focus

6

Process

Management

5 Workforce

Focus

7

Business

Results

4

Measurement, Analysis and Knowledge Management

Organizational Profile:

Environment, Relationships, and Challenges

Criteria for Performance Excellence Framework: A Systems Perspective

LeTCLiG

Performance Levels (Le)

• Are key results missing? What levels are provided? Is the measurement scale meaningful?

Trends (T)

• Are trends provided? Are the results favorable or unfavorable or flat? What is the rate of change in the trend?

Comparisons (C)

• Are comparisons provided? Are the comparisons relevant? Are the comparisons industry averages or best-in-class?

Linkage (Li)

• Do the results link to Key Factors or Process Items that are important to the applicant? Are the results segmented?

Gaps (G)

• Are there important results not reported or addressed?

0%

20%

40%

60%

80%

100%

2005 2006 2007

Customer Satisfaction

DAS

Coral Springs (Baldrige)

HCTC (Sterling)

ACSI Federal Govt.

AIMS

Aging Information Management System

Designed for Georgia’s Aging Network

AIMS

• Standardized statewide database

• Web-based

• One centralized system instead of

multiple stand alone systems

• Flexible programming

AIMS

• “Team Georgia”- based system: developed,

maintained and updated with user input

• Self-service application: users enter data

and run reports

• Required for data collection and reporting

DAS, AAAs and Providers/subcontractors

AIMS

• Provides high degree of accountability by linking programmatic and financial data

• Produces verifiable data on a uniform statewide basis

• Facilitates consistent implementation of aging programs statewide

AIMS

• Is a readily available tool that measures

efficiency, distribution of services and

compliance measures

• Plays a major role assuring access to vital

information and analysis

• Generates many versatile programmatic and

administrative reports that are used to manage

and evaluate programs

AIMS

• Provides all data needed for federal/state

reporting - no data entry into separate

tracking system needed

• Provides information to track trends and

client outcomes

• Has been recognized as a "best practice"

system model nationally

AIMS Users by Program

3,656 Total AIMS Users

1,061

558

519

329

266

212

189

121

39

255

107

0 200 400 600 800 1,000 1,200

Number of AIMS

Users by Program

ADRC/Gateway

(New)CCSP Care

Managers (New)SCSEP

Elder Abuse

PreventionLTCO

ELAP

Adult Protective

ServicesArea Plan/Financial

CCSP

GeorgiaCares

HCBS

AIMS Current Reports by

Program348 Total Reports

0 20 40 60 80 100 120

EAP

ELAP

All

NAPIS

Finance

Area Plan

GeorgiaCares

LTCO

APS

HCBS

CCSP

• Continue to strive to manage using data by having timely and accurate data

• Need for development of new reports as users and programs need them

• Modify AIMS to meet changing programs and priorities of aging network

• New development in process now for release in calendar year 2011

AIMS is a work in progress due to

constant changes in the aging network

Questions

Contact information:

Arvine Brown – arbrown@dhr.state.ga.us

(404)657-5278

Sharise Thurman – svthurman@dhr.state.ga.us

(404)657-5281

Deborah Price – gdprice@dhr.state.ga.us

(404)657-5265

Thank You!