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RE: structured decision-making
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<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Hello,<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Sheri raises good questions. No matter how good a tool is, it’s
only as good as its use in the field. I’d love to report on a recently
completed study that addresses part of this question, but the jurisdiction has
not approved it for release just yet. It will show that fidelity can be
improved by involving supervisors in a comparative case reading approach. More
importantly, improved fidelity leads to improved outcomes.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>There are some ways we look at fidelity administratively. The
most crude way is simply to measure the extent to which assessments are being
completed. We see implementation as a developmental process, with simply
getting into the habit of completing the correct assessments at the correct
time is a necessary, and hopefully brief, first step. Using aggregate data to
identify patterns, it is possible to notice where it may be necessary to
provide refresher training, or identify other barriers to completion and
develop solutions. <o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>More importantly, the next step is to check quality of
assessments. Supervision is vital to this function. When key decisions are
being discussed, the appropriate decision tool needs to be part of the
discussion. We strongly encourage adopting a systematic approach to supervisory
case reading. A small random sample of records is reviewed and rated on key
measures of fidelity. Perhaps most important is the question of whether there
is concurrence between the completed tool and the narrative. The test is
whether the supervisor, having only the narrative to rely on, would have
completed the tool exactly the same. <o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Finally, the ultimate fidelity question is whether the results
of the assessment are shaping practice. This can be observed on a case level
basis by the final question in the supervisory case reading review. For
example, if a risk assessment result was very high risk, was a case opened? If
it was low risk, was it NOT opened? When priority needs are identified, does
the case plan address them? This fidelity question can also be observed using
aggregate data. What % of low, moderate, high and very high risk cases were
opened? Are higher risk families receiving more worker contact? <o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>We do ask these questions during technical assistance visits and
using management analytics, including SafeMeasures, but this has not been a
formal study. There is no doubt in my mind that our field needs to focus on
implementation of good models, whether SDM or other evidence-based practices.
Research in this area would contribute significantly. Thanks for raising the
question.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
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<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>Raelene Freitag, MSW, Ph.D.</span><span style='color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>Director</span><span style='color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>Children's Research Center</span><span style='color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>426 S. Yellowstone Dr. #250</span><span style='color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>Madison, WI 53719</span><span style='color:#1F497D'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:#1F497D'> <o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>608-831-1180<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:#1F497D'>www.nccd-crc.org<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:#1F497D'> <o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:7.5pt;color:#1F497D'>Please do not
send any identifying or confidential information (such as names,
birthdates, social security numbers) via e-mail. It is possible
for third parties to intercept information transmitted in
an e-mail. Identification numbers (such as case or
referral numbers) may be included where necessary. Intercepting persons
cannot use these numbers to identify a client unless they have access
to the host application or database.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:#1F497D'> <o:p></o:p></span></p>
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<p class=MsoNormal><span style='color:#1F497D'> </span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
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<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>
<p class=MsoNormal style='margin-left:.5in'><b><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;
font-family:"Tahoma","sans-serif"'> bounce-1609119-6833790@list.cornell.edu
[mailto:bounce-1609119-6833790@list.cornell.edu] <b>On Behalf Of </b>D F
MCMAHON<br>
<b>Sent:</b> Wednesday, July 18, 2007 9:30 AM<br>
<b>To:</b> Child Maltreatment Researchers <br>
<b>Subject:</b> structured decision-making<o:p></o:p></span></p>
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<p class=MsoNormal style='margin-left:.5in'><o:p> </o:p></p>
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<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>I''d like to know about
studies of the fidelity with which structured decision-making is
implemented by caseworkers, to what extent training in the
decision-making method affects fidelity, and to what extent the
"extraordinary pressure" on caseworkers who witness situations
"beyond the scope of typical human experience" impacts their reliance
on structured decision-making. Or is "nuance" (of the individual
case) as experienced by the caseworker the driving force in decision-making? </span><span
style='font-size:10.0pt;font-family:"Verdana","sans-serif";color:black'><o:p></o:p></span></p>
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<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Verdana","sans-serif";color:black'> <o:p></o:p></span></p>
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<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>Also, the same question in regard
to lay GALs. </span><span style='font-size:10.0pt;font-family:"Verdana","sans-serif";
color:black'><o:p></o:p></span></p>
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<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Verdana","sans-serif";color:black'> <o:p></o:p></span></p>
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<p class=MsoNormal style='margin-left:.5in'><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'>Sheri McMahon</span><span
style='font-size:10.0pt;font-family:"Verdana","sans-serif";color:black'><o:p></o:p></span></p>
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