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Implementation of the WFI-EZ in a Multi-Site Wraparound Agency. March 3, 2014. Choices. Care Management Entity System of Care Wraparound Managed Care Established in 1997 Over 1500 youth served daily. Agenda. Choices experience with the WFI Integrating the WFI-EZ into Practice - PowerPoint PPT Presentation
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Implementation of the WFI-EZ in a Multi-Site Wraparound Agency
March 3, 2014
Choices
• Care Management Entity– System of Care– Wraparound– Managed Care
• Established in 1997
• Over 1500 youth served daily
Agenda
• Choices experience with the WFI
• Integrating the WFI-EZ into Practice
• Using the WFI for Quality Improvement
Experience with WFI 3.0 and 4.0
• Wraparound Comparison Study– Dawn Project– University of Maryland
• Choices Technical Assistance Center– Subcontractor– Choices Outcomes and Evaluation Staff
Experience with WFI 3.0 and 4.0
• Advantages– External evaluation– Trained interviewers– Alignment with phases and principles
• Disadvantages– Staff resources– Completion rates– Limited assessment options
WFI-EZ
• Short-form– Wraparound Fidelity– Youth Outcomes– Satisfaction
• Self-Report– Paper– On-line– Interview
Part 1
Integrating the WFI-EZ into Practice
Administration Options
• On-line– Care Coordinators introduce– Email to caregivers– Survey Monkey
• Challenges– Caregivers have limited access to Internet– Reading levels
Administration Options
• Paper– Care Coordinators introduce– CCs give survey to families• Sign sealed envelope and return• Mail in stamped envelope
• Challenges– Potential for bias– Reading levels
Administration Options
• Interviews– Program staff– CCs introduces– Conducted by phone
• Challenges– Resource cost– Successful contacts with caregivers– WFI-EZ format
Implementation Process
• Allowed sites to select method
• Generated random samples
• CCs completed WFI-EZ on one youth
• 30 days to get completed surveys from caregivers
Results
• 3 of 4 sites selected paper surveys
• 1 site conducted phone interviews
• Response rates– Interviews (44%)– Paper (22-36%)
Results
• Consistent data quality
• Bias from CC involvement not observed
• Cost/benefit analysis
Next Steps
• 2nd administration underway
• Improve CC introduction to WFI-EZ
• Formalize mechanism for returning paper surveys
• Incentives for caregivers and youth
Part 2
Using the WFI-EZ for Quality Improvement
Importance of the WFI-EZ
• Family voice
• Fidelity monitoring vs. task management
• Opportunities for quality improvement
Quality Improvement
• Multiple levels of analysis
• Opportunities for celebration
• Common areas for improvement
• Site-specific strengths and needs
18
Total Caregiver Fidelity Score
High Fidelity (85% and above)Good Fidelity (75% - 84%)Adequate Fidelity (65% - 74%)
WFI Louisiana - October 2013
Wraparound Fidelity Principles
Outcomes Based
Teamwork Natural Supports
Needs Based Strength and family driven
WFI Total Score
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Wraparound
Adequate
Not Wraparound
Good
High
Strength and Family Driven
Wraparound
Adequate
Not Wraparound
Good
High
B1: Had
a majo
r role in
choosin
g team
B3: Fam
ily described
vision
B11: Celebrat
e succe
sses a
t each
mee
ting
B14: Stra
tegies ti
ed to
family
likes
B17*: Te
am m
embers
do not underst
and fa
mily
Strength
and family
driven
Overal
l0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Satisfaction
DC Indiana Louisiana Maryland Choices0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
I am satisfied with the wraparound process in which my family and I have participated.
% o
f Car
egiv
ers S
tron
gly
Agre
e or
Agr
ee
Outcomes
Cause stress or strain on family
Disrupt home life Interfer with success at school
Difficulty developing friendships
Difficulty participating in community activities
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Quality Improvement
• Multiple Levels– Agency– Programs – Teams
• Multiple Data Sources– Fidelity– Process measures– Outcomes
Conclusions
• Integrate WFI-EZ into practice
• Balance response rates and resources
• Quality improvement requires multiple types of data
• Ongoing assessment is important
Thank You!
Vicki Sprague Effland, Ph.D.Director, Outcomes and EvaluationChoices, Inc.4701 N. Keystone Ave., #150Indianapolis, IN 46205
(317) 205-8232