ECKERD - RAPID SAFETY FEEDBACK [NO AUDIO] John Zalenski Programs Administrator Continuous Quality Improvement John: The Rapid Safety Feedback pilot is an effort to use an advanced kind of data analytics to identify the children who may be at risk of serious injury or even fatality, and to use that information to intervene in a real timely way in order to affect a much better outcome. [NO AUDIO] Angela Wood Programs Supervisor Quality Assurance Angela: The approach that we take is that it identifies those cases that need to have more eyes on, needs to really look at to ensure the safety of the children. So, we notify the workers and the supervisors that this case has been identified on the prediction and let them know it's going to be part of the Rapid Safety Feedback process. The whole intent is to make them aware that this family does have characteristics that are similar to those families that have ended in tragic situations, but we also include the eight questions that we are going to use to review to ensure that all of the safety areas are covered and cover thoroughly to ensure the safety of that child. So really it's just putting the focus on safety within the hope or the intent that we identify some cases upfront, but this spreads out through practice on all cases. [NO AUDIO] Oklahoma is the first state to utilize the Eckerd Rapid Safety Feedback System or RSF for data analysis. John: As a decision-making support system this technology is really good because it can scan data very quickly for these risk factors, and then bring up this heightened probability so that a worker can really pay attention, "Oh, this has these characteristics, so I am going to have a staffing. I am going to look closely at the family and figure out what we can do to help the family get to a better outcome." [NO AUDIO] Characteristics for Evaluation Number of previous referrals, Frequency between referrals (days), Repeat perpetrator, Age @ first referral, Gender, Allegation, Substance abuse, Neglect, Physical abuse, Exposure to domestic violence, Threat of harm, Sexual abuse, Severe sexual violence Angela: We stress that it it is a collaborative, that we are there to assist, as far as the Quality Assurance team is there to assist in making those good safety decisions. [NO AUDIO] Eight Safety Questions Based on some reviews that Eckerd pulled, they looked at characteristics that were found during past reviews, and there were several characteristics that were similar throughout. There were common themes, and the eight questions were based on those themes that were found. [NO AUDIO] OK RSF Review Questions Beginning Points for Safety Analysis 1. Is the totality of accessible family history (prior referrals, law enforcement and service records, etc.) sufficiently assessed and utilized in decision making? 2. Are interviews with the family and observations sufficient to identify and respond to present danger and impending danger? 3. Are interviews with the family and observations sufficient to identify protective capacities and respond to deficits appropriately? 4. Is communication with case stakeholders (collaterals, referred service providers, legal) relevant and sufficient? 5. Is a clear link established between the maltreatment and harm (or threat of harm) to the child, as well as a perpetrator identified; if not are efforts to do so sufficient? 6. Are safety plans and immediate protective action plans utilized effectively and are external controls sufficient to prevent maltreatment? 7. Are appropriate services offered to the family and is follow through ensured? 8. Does the supervisory review identify gaps and provide appropriate and sufficient guidance regarding all of the above? Is accountability to that guidance ensured? John: It's the ability to look at kind of the dynamic interaction of all the risk factors that is the difference at this point. Angela: The final question, probably the most key question to all of this is the supervisory review because we are trying to really improve the supervisors capacity and abilities to review the worker's work, staff cases with the worker, and when there are gaps in information that is needed, that supervisor can give guidance and that direction. [NO AUDIO] Oklahoma County is now piloting the analytic software created by Mindshare for Eckerd Kids. John: The technological means to help sort the data, to help highlight correlations that are important to pay attention to, to engage in some kind of heightened probability that we refer to as predictive, is really of growing importance. On the other hand, we don't want to ever be in the place where we're using technology to drive decision-making and minimize the human element of decision-making. Angela: The review process and the staffing, if we can't answer yes to all eight questions, we end up having a staffing. And during that staffing we have conversations about safety related information and if there's information missing and we discuss what could be pertinent to make a safety decision, sound safety decision. And through that the workers and supervisors develop action items. And those action items are related to safety and they're given a due date. We might want to make sure that it gets done, gets done timely, because these are safety related items. And we need this information to make, like I said, a good, sound safety decision. So we document all that in Mindshare. And it includes the due dates, what the action items are, the due dates, and then when we complete the review, we do an initial review, and set our action items, and then at the end of the action items we do a second, follow-up review to ensure that we can answer "Yes" to all eight questions. And if we can answer "Yes" to all eight questions, then we are done. And we send a notification out that the process is completed, that the review was done, done well, and we move to the next one. [NO AUDIO] Mary Phillips RSF Reviewer Programs Field Representative Continuous Quality Improvement Nita Newport RSF Reviewer Programs Field Representative Continuous Quality Improvement John: Good child welfare practice depends on relationships. And we need to use all of the tools that we have access to in order to support good decisions. And the more and better we can analyze data, that can really be supportive to that. In the end, though, it really depends on a social worker and a family forming a relationship that can help them to do better in their lives and improve the lifelong opportunities for the kids. [NO AUDIO] Tom Ward of White Fields Inc. and Eckerd Kids provided funding for the pilot program. Angela: Predictive analytics is a great tool to really identify those cases that need to be focused on. But it's just part of the process. The overall process is to really ensure what work's being done, that we're focusing on safety and ensuring the safety of the children. John: It's really important to emphasize that it's not about the pilot and it's not about who gets to speak to it, but it's really about the staff, the child workers and supervisors and district directors, that are everyday putting together this work with ensuring safety for families and helping families work toward better outcomes for themselves. And I wanted to also add that it's a really great time to be a part of Oklahoma DHS. We've got really strong leadership under Jamie Ladoux who's very supportive, and interested in supporting staff and supervisors, foster parents, and everyone who helps put this system together, day by day. It's just really an honor to be a part of it.