A critical component of any agency’s continuous quality improvement (CQI) system is the ongoing, periodic review of case files taken from a statewide case sampling of children who are or were served under the title IV-B and IV-E programs. These quality assurance (QA) case reviews should be performed by skilled QA case reviewers who collect information to assess practice, services, and outcomes for children and families, and to determine whether specific requirements have been met.
Pivotal to gaining a complete picture of the case is conducting case-related interviews, or interviewing various parties involved in the cases. QA case reviews employing a comprehensive case review instrument as well as case-related interviews will yield meaningful data that can be used to make individual, unit, division, regional, and statewide practice improvements.
Through these thorough case file reviews and interviews, the State can better understand how the agency’s policies, procedures, and practices are impacting children and families. Assessment of this detailed case-level data helps in evaluating the quality of services being delivered, and how the agency can better ensure children's ongoing safety, permanency, and well-being. The State’s policies and manuals should provide clear guidance for carrying out and completing case reviews.
The QA case review process should:
- Cover the entire State
- Have clear, consistent written policies and processes
- Be underpinned by strong infrastructure
- Include interviews of case participants
- Ensure reviewer skill
- Promote inter-rater reliability
- Identify, measure, and clarify practices that guide safety, permanency, and well-being in terms of daily practice
The QA case review activities in all States, whether they are State-administered, county-administered, or privatized States, should take place with consistency and quality statewide, with ongoing involvement and monitoring by the State’s CQI oversight division. Case review activities are an integral part of an agency’s CQI program as a whole. The meaningful results generated by QA case reviews, considered in conjunction with other CQI activities, will help ensure and sustain high quality services across the agency.