Quality Improvement Processes - Department of Mental Health

The purpose of the design and implementation of the Countywide QI Program is to ensure an organizational culture of continuous self-monitoring through effective strategies, best practices, and activities at all levels of the system. The OAO-QID team works to engage and support the Service Area Quality Improvement Committee (SA QIC) members in QI processes related to the QI Work Plan, specific Performance Improvement Projects (PIP) activities, and other QI projects conducted at the SA level.

QI Work Plans
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The OAO-QID works in collaboration with Departmental staff to establish annual and measurable QI Work Plan goals to evaluate performance management activities. The QI Work Plan Goals are categorized into the following seven domains:
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Service Delivery Capacity
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Accessibility of Services
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Beneficiary Satisfaction
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Clinical Care
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Continuity of Care
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Provider Appeals
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Performance Improvement
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Consumer Perception of Satisfaction
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The OAO-QID is responsible for the formal reporting on annual measurement of consumer perception of satisfaction in six areas, namely: General Satisfaction, Perception of Access, Perception of Quality and Appropriateness, Perception of Participation in Treatment Planning, Perception of Outcomes of Services, Perception of Functioning, and Perception of Social Connectedness.
Performance Improvement Projects (PIP)
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As a part of the External Quality Review Organization (EQRO) requirements and mandated by the Code of Federal Regulations, Title 42, the QI program is responsible for collaborating on SA QI projects and PIPs. The OAO-QID is responsible for coordinating, organizing, and supporting PIPs from and throughout the organization. Each year, the OAO-QID conducts a clinical and non-clinical PIP. The PIPs are conducted to ensure that selected administrative and clinical processes are reviewed to improve performance outcomes. The OAO-QID collaborates and coordinates related QI activities with many of the Divisions and Units within LACDMH.
Service Areas Quality Improvement Committees (SA QICs)
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The OAO-QID acts in coordination with the service delivery system. The Departmental Quality Improvement Council meets monthly and includes standing representation from each of the eight Services Areas (SAs), LACDMH programs and Divisions, and other stakeholders. All SAs facilitate their own SA QICs. Each SA QIC has a Chairperson representing Directly Operated (DO) Providers and most have a Co-Chairperson who represents the Legal Entities (LE)/Contracted providers.

The SA QIC Chairperson and Co-Chairperson are representative members of the Departmental Council (QIC). The SA QIC meetings provide a structured forum for the identification of QI opportunities to address challenges and barriers unique to a SA. At the provider level, all DO and LE/Contracted providers participate in their own organizational QIC. In order to ensure the QIC communication feedback loop is complete, all SA Organizational providers are required to participate in their local SA QIC. This constitutes a structure that supports effective communication between providers and SA QICs, up to the Departmental QIC, and back through the system of care.

An additional communication loop exists between the SA QIC Chairperson and/or Co-Chairpersons and the respective SA Chiefs and Service Area Advisory Committees (SAACs). The SAACs are comprised of consumers, family members, providers and LACDMH staff. The SAACs provide valuable information for program planning and opportunities for program and service improvement. SAACs are a centralized venue for consumers and family members to participate.