Ohio’s Cuyahoga County Division of Children and Family Services (CCDCFS) has been working to paint a clearer picture of how child welfare cases are moving through its system.
Its metaphorical paintbrush for this work? Continuous Quality Improvement (CQI) reviews, which expand the use of data, voices and viewpoints in the decision-making process. By filling in information gaps, CQI reviews help agencies better support staff efforts to improve policies and practices.
In Ohio, this approach yielded encouraging results, including a sharp uptick in the percentage of safety assessments completed on time, according to a report by the Annie E. Casey Foundation called Better Decisions for Better Results.
“As we all know, child welfare has a lot of processes and policies,” says CCDCFS Director Cynthia Weiskittel, “But, unless you are actively analyzing your cases to make sure they reflect those policies, you have no way of knowing if you’re actually doing what you intended to do.”
After evaluating its case flow in March 2017, CCDCFS learned that just 24% of safety assessments were completed within the required seven-day period.
Using CQI reviews, CCDCFS eliminated delays and added staff trainings focused on best practices. By June 2018, 44% of safety assessments were completed within the required seven-day period; by June 2019, 72% of assessments hit this mark.
CCDCFS’s approach involves a monthly meeting where agency stakeholders convene for a four-hour honest conversation about the data, policy and practice. At each session, two units present their work and identify one specific case for discussion with a leadership panel. More than 40 leaders from departments across the agency — including legal and placement — can also participate by submitting questions.
These monthly meetings utilize ChildStat, a management accountability and quality improvement process developed in New York City, which the Cuyahoga team has tailored meet their specific needs.
Weiskittel — who serves on the leadership panel — notes that her role involves a lot of listening, posing probing questions and striving to consider the case workers’ perspectives. Staff, on the other hand, have grown quicker to ask questions and raise concerns about their work.
“For a system to improve, there has to be a hard conversation. But it also matters how you have that conversation,” says Weiskittel. “It’s important for staff to see that their director may not always have the answer; to be open to hearing new ideas from staff at any level and to showcase how honest conversations and collaborative processes can help create the solution.”