Integrated Quality Management Functions
Quality Assurance Directives and Related Tools GridThe Integrated Quality Management Functions are standardized processes designed to monitor and improve services for individuals in the areas of: Health, Environment/Safety, Consumer Rights, Services/Staff and Money. Data from quality assurance monitoring is used to evaluate the performance of the service delivery system, remediate identified issues and develop system improvements.
A description of major quality management processes follows:
Service Monitoring: Service Coordinators monitor for effective and efficient provision of services and supports that enable the individual to achive his/her basic needs and personal goals. Service Coordinaors conduct monitoring through face to face visits to the individual. The following areas are monitored: Health, Environment/Safety, Consumer Rights, Services/Staff and Money. Related Division Directive: 3.020
Complaint Response: When the Department of Mental Health, Office of Consumer Safety , receives a complaint regarding DMRDD supports and services, the Quality Assurance Unit and appropriate agency staff are notified. State Quality Assurance staff follow up on all reported complaints to assure resolution. Concerns related to health, environment/safety, rights, services or money are entered into a database for tracking. When action taken results in recommendations, it is incorporated into the Quality Management Plan for the facility or in the individual's personal plan as appropriate. Related Division Directive: 3.050
Fiscal Reviews: Regional Center and DMRDD Central Office staff complete fiscal reviews of provider agencies to ensure that funds appropriated for services are used in accordance with service requirements. Related Division Directive: 5.070
Health Identification Planning System (HIPS): HIPS is the Division's QA monitoring process for the discovery and remediation of health and safety concerns for individual's in DMRDD community residential services. A Health Inventory tool is completed on all persons entering community placement and annually, as well as when there are significant health changes. Regional Center RNs complete Nursing Reviews on individuals with a defined score on their health inventory. Nursing Reviews evaluate the provider's health supports and services and evaluates the individual's response to treatment and supports identifying unmet healthcare needs. Related Division Directive: 3.090
Mortality Reviews: Following the death of individuals receiving services, Regional Center RNs conduct an evaluation of the circumstances surrounding the death. The evaluation ascertains if all necessary measures were taken to provide for the health, safety and welfare of the individual and determine if there were any identifiable risk factors that could affect the health, welfare and safety of others receiving that service. Related Division Directive 3.070
Personal Plan Reviews: Personal plan reviews ensure that the individual planning process leads to person centered quality outcomes for individuals, evaluates the effectiveness of support services in meeting the individual's needs and identifies service strengths as well as areas in need of enhancement. Four areas are reviewed: Local reviews are conducted of the level of care determination process, A minimum of 500 plans per year statewide are reviewed in accordance with the Person Centered Planning Guidelines, the "Day in the Life" review is conducted on a specified number of individuals and SAFE reviews determine the effectiveness in achieving quality outcomes for people.
For additional information regarding these or other quality assurance processes, please contact the State Quality Assurance Team Member in your area.
