| Performance Outcome System
Quality Improvement and Program Compliance Division
Children & Youth Services
Performance Outcome: Data Management
Data collection for Orange County Children and Youth Services (CYS) began in December 1999. Through the end of December 2000, a total of 13,236 instruments had been completed and processed. These instruments included measures of clinical status and consumer satisfaction. Currently, an average of 1,220 instruments are processed each month.
Each instrument is reviewed by QIPC staff to make sure that is has been correctly completed, and returned to the clinic if changes are needed. During the first half of 2000, error rates were high, with about one-fourth to one-third of submitted instruments being returned for correction. In December 2000, the error rate had fallen to 1.4%.
When instruments are received by QIPC, they are sent to Information Technology for processing, returned to QIPC, and then returned to the originating clinic by mail. The average time for this process to be completed was calculated monthly, and has ranged from 9 to 11 days.
Demographics
As of February 15, 2001, 3,265 children were entered into the Performance Outcome system. The average was 12 years, and 65.1% of the children were boys. Nearly half of the children were Caucasian (49.5%). The ethnic distribution is shown here:
Eighty percent of the children are living at home with their parents or other caretakers. The placement status is shown in the figure below:
Clinical Status
*NOTE: Changes in Community, Drugs, and Thinking scales are non-significant.
The Child & Adolescent Functional Assessment Scale (CAFAS) is completed by the child’s mental health provider. Problems in 8 areas are rated as 0: Minimal, 10: Mild, 20: Moderate, or 30: Severe. Pairs of scores, representing the first and last completion of the CAFAS, were compared for 276 children. The administrations were separated by an average of 217 days.
The figure above shows that mean scores were highest on the Behavior Toward Others, Moods, School Performance, and Home Performance scales. This indicates that the problems measured by these scales are more frequent or more severe. These scales measure angry, mean, and argumentative behavior (Behavior Toward Others), low self-esteem, depression, and anxiety (Moods), low grades and truancy (School Performance) and cursing at home, running away, and resisting chores (Home Performance). Significant improvement was seen in all of these areas. Less common or less severe problems in these children included suicidal and self-mutilating behavior or talk (Self-Harm), illegal and delinquent behavior (Community), drug and alcohol abuse (Substance Use), and psychotic thought processes (Thinking). These behaviors appeared more resistant to change. There was a significant reduction in self-harming behavior, but not in delinquency, substance abuse, or psychotic thinking.
Consumer Satisfaction
The CSQ-8 is an 8-item measure of consumer satisfaction. The items are rated from 1: Poor to 4: Excellent. Based on 781 surveys, collected as of February 15, 2001, consumers feel quite satisfied with the services they are receiving. As shown in the figure below, mean ratings of all CSQ-8 items range between 3: Good and 4: Excellent.
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