Questions to Ask:The Office for People With Developmental Disabilitiescontinues to support system change through a variety ofquality initiatives. These initiatives are the cornerstone ofOPWDD and service provider efforts to enhance the lives ofindividuals with developmental disabilities and ensureindividuals are achieving valued outcomes through person-centered planning, choice, access and communityinclusion.

Many of the initiatives involve looking at the funding anddelivery of services through a different lens:

• Agency Quality Performance: How do wecomprehensively assess provider quality?

• Home and Community Based Settings Standards:Howdo we rethink outcomes and supports for individuals,including person-centered planning, as well as physicalenvironment and communities in which these supportsare provided?

• Direct Support Professional Core Competencies andCode of Ethics: How do we enhance tools and trainingfor direct support staff who are the foundation of servicedelivery for individuals?

• Transformation Agenda: How we reevaluate, assessand change the system to enhance employment andself-direction opportunities, housing and residentialsupports, increase coordination in service delivery andincrease flexibility and responsiveness?

The purpose of this toolkit resource is to:

• Establish how a QI Plan and the planning process areintegral to creating a culture of quality and systemchange to ensure the delivery of high quality servicesand quality of care

• Provide steps to developing a QI Plan

• Identify components of an effective QI Plan

• Provide examples of QI in practice

To promote the delivery of high quality services, agenciesshould consider the following1:

• Leadership: Is there a process to hold employeesaccountable for QI? Are adequate resources dedicatedto building a quality culture? Do leaders have a clearvision of what a quality culture means for theorganization currently and in the future? Do leadersengage in data drive decision making? Has leadershipadopted organizational policies and plans that support aculture of quality?

• Employee Empowerment: How do employees accountfor time dedicated to QI? Is QI incorporated intoemployment position descriptions? Is QI incorporatedinto the employee performance appraisal process? Doemployees have the ability to make and/or have inputinto process improvements? Is there a process foremployees to formally recommend and/or initiate QIprojects?

• Person-Centered Planning and Outcomes: Is there amechanism to assess satisfactionand whether valuedoutcomes are beingachieved among individual’s beingserved? Is data from the person-centered planningprocess used for process improvements? Are the needsof individuals appropriately considered during decisionmaking?

• Teambuilding and Collaboration: Is there a mechanismfor effective communication and information sharingacross and within teams? Is there a process to monitorteam performance?

• QI Infrastructure: Are specific staff assigned formonitoring QI initiatives? How is progress beingmeasured? Are QI strategies and initiatives alignedacross the organization? How is data being collectedand analyzed to determine performance and identifytrends?

Quality Improvement and Building a Quality Culture:

Improving Provider Quality

• Continuous Quality Improvement: Do employeesquestion, on an ongoing basis, how processes can beimproved and identify those areas for improvement?Once a QI project is adopted and implemented, isthere a process to evaluate whether it wassuccessful? If a project does not yield expectedresults, is there further examination into the cause andsteps taken to address? Are QI principals incorporatedinto daily activities for identifying issues, addressingthe concerns and evaluating progress?

Therefore, quality not only needs to be a part of agencyculture, but requires support from all levels of theorganization, resources and training.

____________________________________________1 Adapted from “Roadmap to Culture of QualityImprovement,” available at http://qiroadmap.org/change-management/

For More Information: quality@opwdd.ny.gov