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Children's Medical Services - Special services for children with special needs
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Module One: Lesson One

Early Steps Quality Assurance (QA) and Technical Assistance (TA)

Early Steps implements a focused, data-driven, quantitative, outcome-based, continuous improvement and focused monitoring system to determine compliance with a defined set of performance indicators. The design of the system provides for continuous improvement through ongoing planning, implementing, analyzing, improving, and evaluating the process. The system consists of two major processes: Quality Assurance (QA) and Technical Assistance (TA). The foundation of this system is the identification of performance indicators and probes in the following cluster areas of achievement:

rulers and scissorsCluster Area I
Family Centered Services
Cluster Area II
Early Intervention Services in Natural Environments
Cluster Area III
Cluster Area IV
General Supervision

Quality Assurance (QA)

On a scheduled timetable, all Local Early Steps receive a desk review to determine their level of achievement with specified performance indicators. The QA Review Team consists of the QA Coordinator, a representative of the Department of Education (DOE), and the TA Liaison for the Local Early Steps in the process of review. The desk review will consist of a review of the following information:

  • QA Data Matrix
    The Early Steps Data Center provides the QA Data Matrix and randomly selected sample listings of child records and provider listings for review in each Local Early Steps. The QA Review Team will analyze the information contained in the Data Matrix to determine the level of achievement with specific data-related performance indicators.
  • Self Assessment Information
    Local Early Steps complete a record review of child records and provider and Service Coordinator records.
  • Family Survey Results
    Local Early Steps provide a family survey instrument to all families encountered by Service Coordinators, Family Resource Specialists, and others that is then analyzed.

QA scores are represented in terms of percentage of achievement. In addition to scoring of probes, the QA Review Team analyzes the results of previous QA reviews to compare to the current year results. This will provide information on trends in improving or decreasing compliance, and possible root causes of lower levels of achievement. The QA Review Team also analyzes the QA results for consistency (e.g., compliance with data standards and family interviews is low while self assessment of child records shows high compliance rates).

Technical Assistance (TA)

The link between the Quality Assurance (QA) process and Technical Assistance (TA) process enables Technical Assistance (TA) Liaisons to develop Continuous Improvement Plans (CIP) based upon Quality Assurance results. A QA Report is developed by the QA Coordinator that reflects the level of achievement for each of the performance indicators, cluster areas, and overall level of achievement. Following the submission of the QA Report to the Local Early Steps Director, the TA Liaison for the Local Early Steps facilitates a conference call with the Local Early Steps Director. The purpose of this contact is to review the QA findings and to begin developing a Continuous Improvement Plan (CIP) that reflects the steps and technical assistance activities for each Local Early Steps to reach a higher level of achievement in each of the four cluster areas. The CIP includes both the steps to be taken by the Local Early Steps, as well as steps that to be taken by the TA Liaison in order to reach higher levels of achievement. The Local Early Steps Director and the TA Liaison consult to finalize the CIP.


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