For Each of the Months in the Timeframe Reviewed
Quarterly Report Evaluation Tool
Entity Name:
Criteria / Guideline / Yes / No / N/A
(Met by exception,
count as yes) / Comments
The Quarterly Report contains the review and analysis of progress made to achieve the objectives, including data and data analysis where available. / The reviewer will indicate that the Quarterly Report contains the review and analysis of progress made to achieve the objectives, including data display and analysis where available. If yes, mark Y. If no, mark N. / Refer back to the Entity’sfinal QM plan for specific performance measures.
The quarterly report includes data analyzed for each performance measure:
- for each of the months in the timeframe reviewed
- The target objective percent is calculated and analyzed to identify if the Entityis on track to meet their objective.
- Baseline development is described.
In the event where the Entityhas described they are engaged in ongoing monitoring rather than developing an objective, the Entity documents the findings from their ongoing monitoring. / The reviewer will indicate that in the event where the Entityhas described they are engaged in ongoing monitoring rather than developing an objective, the Entity documents the findings from their ongoing monitoring. / The Entity will identify the focus area and desired outcome; in the objective section the Entitywill indicate they are engaged in ongoing monitoring (of restraint, e.g.).
The Quarterly Report identifies barriers to achievement of objectives where they exist. / The reviewer will indicate that the Quarterly Report identifies barriers to achievement of objectives where they exist. If yes, mark Y. If no, mark N. If not applicable, mark N/A. / Barriers that adversely impact the achievement of the target objective are identified; or, if unknown, the Entitynotes what efforts are in process to determine or identify barriers.
The Quarterly Report describes what activities the Entityplans to carry out to overcome any barriers that exist or to sustain achievement of objectives and continue progress. / The reviewer will indicate that the Quarterly Report describes what activities the Entityplans to carry out to overcome any barriers that exist or to sustain achievement of objectives and continue progress. If yes, mark Y. If no, mark N. / When barriers are identified, action steps or strategies to address them are included in the PDCA column of the Quarterly Report.
The Entity’sQuarterly Report describes how key stakeholders are involved in the achievement of QM Plan objectives. / The Entity’sQuarterly Report describes how key stakeholders are involved in the achievement of QM Plan objectives. Key Stakeholders include: Waiver participants, their family members or representatives, and Waiver providers. If present, mark Y. If not present, mark N. / Each group of stakeholders is listed and how they are involved is noted.
The Entity’sQuarterly Report describes how and on what schedule progress on the implementation of the Entity QM Plan is reported to the County/Joinder MH/IDBoard or Entity Board of Directors. / The Entitydescribes how and on what schedule progress on the implementation of the Entity’s QM Plan is reported to the County/Joinder MH/IDBoard or Entity Board of Directors. (Acceptable documentation might include: Reports submitted to the Board, minutes of the Board meeting, etc.). If Yes, mark Y. If No, mark N. / The dates of meetings when reports are submitted to the Entity’sExecutive Staff are included.
Entity Quality Management Strategy_Office of Developmental ProgramsRevised 02 07 131