Quality Improvement Strategies that Work – System Implementation Issue Brief #6

Authors: Kukla-Acevedo, S., Hodges, S, Ferreira, K., Mazza, J.
Publication Year: 2008
Last Updated: 2010-09-02 15:17:10
Journal: NA
Keywords: System Implementation, case studies, system of care

Short Abstract:

The goal of this issue brief is to discuss findings regarding the types of data and data collection procedures systems used to evaluate and monitor their performance. There is a critical need for systems of care to dedicate resources to self-evaluation and monitoring activities. The brief highlights the evaluation activities that systems rely on to continually improve the quality of mental health service delivery to children with serious mental health challenges.


Case Studies of System Implementation is a five-year national study of strategies that local communities undertake to implement community-based systems of care. The purpose  of the study is to understand how factors affecting system implementation contribute to the
development of local systems of care for children with serious emotional disturbance and their

This study used a multi-site embedded case study design. Participating systems were identified through a national nomination process and were selected on the basis of having: (1) an identified local population(s) of youth with serious emotional disturbance; (2) clearly identified goals for this population that are consistent with system-of-care values and principles; (3) active implementation of strategies to achieve these goals; (4) outcome information demonstrating progress toward these goals; and (5) demonstrated sustainability over time.

Data collection included semi-structured key informant interviews, document review, site-based observation, and documented aggregate outcome data related to system implemen-
tation in communities with established service systems. The study included a total of six cases.
Analyses used an intensive and iterative team-based approach

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