Bay Area Quality Management System (QMS)
Overview

Background

Initiated by a three year federal grant (The Systems Change Quality Assurance/Quality Improvement Grant) from the Centers on Medicare and Medicaid Services (CMS), the Bay Area Quality Management System (QMS) is a pilot project applying new and enhanced methods of monitoring, tracking, improving and assuring service quality. The QMS was further developed and refined during and after the grant period to include several components. The QMS project is being applied to individuals who have moved from Agnews to community homes since July 2003 and the provider agencies and staff who support them in these homes. The Bay Area QMS is based on values set forth in the Agnews Closure Plan and described in the DDS’s Strategic Plan, and is consistent with CMS’ Quality Framework. This pilot is in operation at the three Bay Area Regional Centers (i.e., San Andreas Regional Center, Regional Center of the East Bay and Golden Gate Regional Center). The QMS pairs a focus on consumer outcomes and satisfaction with process-oriented support in improving the quality of services and the capacity of provider agencies.

Components

The QMS is made up of the following components:

1) The Quality Service Review (QSR)

The QSR is a detailed, continuous quality improvement, review and certification process involving 37 provider expectations, avenues for observations and input from consumers’ family and friends as well as database tools for regional center professional support staff (i.e., Service Coordinators, Registered Nurses, Quality Management System Specialists  and Psychologists). The QSR establishes consumer and service provider outcomes and expectations that are continuously monitored and supported by regional center, RRDP and DDS staff. Quality Management System Specialist (QMS Specialist) staff at each regional center work closely and directly with service providers in each of the consumers’ homes to observe, analyze and support the improvement of service quality. Information is collected on an ongoing basis from family members and friends, Service Coordinators, QMS Specialists, Registered Nurses and Psychologists. The data is monitored and responded to immediately as well as used in the home’s certification process.

2) The Quality Management Information System (QMIS).

The QMIS is an integrated data system that includes information gathered on both service provider performance and the individuals served by those providers. The QMIS tracks identified follow up issues or technical support needs of the provider, delivers ongoing data on the quality of support services for service provider certifications and provides aggregate system level data for review and analysis by regional centers and the Quality Commission.

3) The National Core Indicator Surveys

As part of the CMS grant, the National Core Indicators (NCI) Consumer and Family Satisfaction surveys were selected to measure individual outcomes and family satisfaction on an annual basis. The NCI surveys are used throughout the U.S., by 24 state developmental disabilities service systems and by one other regional center in California. These tools have been tested for validity and reliability, and they also have the advantage of producing national benchmarks for comparison purposes. The surveys are specifically designed to measure performance and outcome indicators. As part of the CMS grant, two years of initial studies have been commissioned. These surveys include: 1) A study of consumers that have transitioned into the community from Agnews from July 2003 through March 2005 and their families, 2) Medicaid Waiver Adult Consumers from the Bay Area Regional Centers and 3) Family Satisfaction Surveys of the families of Medicaid Waiver Adult Consumers who live in community placement and those that live with family.

4) The Quality Commission

A Quality Commission was established in September 2005 to serve in an advisory capacity to review Bay Area QMS data and reports. The Commission is staffed by the QMS Director and includes six parents, two consumers, two advocates and one provider as members. The primary focus of the committee is to 1) Review aggregate trend data to gauge the effectiveness of the service system (and QSR process) in achieving positive outcomes and, 2) to identify systemic improvement areas and make recommendations for system improvements and capacity building. The Quality Commission makes these recommendations directly to the Bay Area Plan Leadership Group.