Quality Assurance and Quality Improvement in Home and Community Based Services

NORTH CAROLINA

Grant Information

Name of Grantee

North Carolina Department of Health and Human Services

Title of Grant

From Institutions to Communities: Quality Management for North Carolina's Transitioning Populations

Type of Grant

Quality Assurance and Quality Improvement in Home and Community Based Services

Amount of Grant

$475,100

Year Original Funding Received

2003

Contact Information

Steven E. Hairston
919-733-7011
steven.hairston@ncmail.net

Shealy Thompson, Project Director
3003 Mail Service Center
Division of MH/DD/SA Services
Raleigh, NC 27699-3003
919-733-0696
shealy.thompson@ncmail.net

Subcontractor(s)

Yet to be awarded.

Target Population(s)

Individuals in psychiatric institutions, intermediate care facilities for mental retardation (ICF/MR), and child residential treatment facilities who are transitioning to community settings (i.e., "transitioning populations").

Goals

  • Design a comprehensive quality management system to monitor and improve the quality of initiatives to help people transition to community settings from psychiatric institutions, intermediate care facilities for people with mental retardation, and child residential treatment facilities.
  • Implement a demonstration of the quality management system.
  • Evaluate the demonstration and, if successful, develop a plan for expanding the quality management system statewide for all populations with long-term care needs.

Activities

  • Develop tools, protocols, and systems for collecting and managing data to identify problems and successes in structures, processes, and consumer outcomes for the transitioning populations.
  • Conduct follow-up interviews with members of the transitioning populations, using trained consumers and family members as interviewers, to gather information on the transition process, outcomes, and experience.
  • Develop and implement processes to review individual data, rectify immediate problems, and prevent future problems.
  • Train service system staff, consumers and families, and other stakeholders in the philosophy and methods of continuous quality improvement.
  • Recommend an ongoing quality management plan.
  • Conduct staff training to implement the ongoing quality management plan.

Abstract

This Quality Assurance/Quality Improvement project will create a model system to monitor and improve the quality of initiatives to help people transition to community settings ("transitioning populations") from psychiatric institutions, intermediate care facilities for people with mental retardation, and child residential treatment facilities. The project will also devise a plan to test this system and then expand it to all state users of long-term care.

The project will build on three current initiatives in the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS):

  1. The State MHDDSAS Plan to reform the service system into one that has consumer-driven, outcomes-oriented services provided in the most integrated community settings possible; consumer and family involvement in design and implementation of the system; measurable standards of safety, quality, and clinical effectiveness; and a total quality management philosophy;
  2. The DHHS Olmstead Plan for transitioning individuals to communities from state psychiatric institutions, state- and community-based ICFs/MR, and nursing homes; and
  3. The DMHDDSAS Child Mental Health Plan, which includes transitioning children out of child residential treatment facilities and psychiatric hospitals to home and community settings.

A Quality Management Plan for the state mental health/developmental disability, and substance abuse service system will be developed by a team of DMHDDSAS staff, other state staff, consumers, family members, and local stakeholders. A demonstration project, focused on the transitioning populations, will be developed and implemented. For the demonstration, consumers and family members will be hired and trained to interview transitioning individuals about their satisfaction with the quality of their care, the transitioning process, and progress toward their personal goals. The data derived will be used to rectify problems in individual situations and improve the transition process and delivery of services and supports. Data will also be used to inform development of an ongoing quality management plan.

In preparation for the demonstration project, current outcome and satisfaction measures, tools, and methodologies will be reviewed to determine their fit with the goals of the quality management system. A Web-based data system that is currently being developed for collection and management of data on people transitioning out of psychiatric institutions will be enhanced to accommodate data about additional transitioning populations.

Finally, the project will develop a plan for expanding the model into a full Quality Management System for the North Carolina long-term care system.

Note: This Compendium form was not reviewed by the Grantee prior to publication.