Quality Improvement Study

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Overview of the Quality Improvement Study

Using the New Jersey Department of Children and Families' (DCF)  “Guidelines for Expert Evaluations in Child Abuse/Neglect Proceedings” the New Jersey Coordination Center  (NJCC) implemented a statewide Quality Improvement Study (QI-Study) to promote advances in knowledge, policy and practice within the field of child abuse and neglect forensic evaluation and treatment. To inform this work, NJCC conducted a mixed-methods study to explore how forensic evaluations are utilized in the state.

As of the completion of the QI-Study in June of 2019, the NJCC has completed quality reviews of forensic evaluations for five RDTC catchment areas in New Jersey: Audrey Hepburn Children's House catchment area, CARES catchment area, Dorothy B. Hersh catchment area, Jersey Shore Medical Center Satellite Office catchment area, and Metro catchment area. Sampled forensic evaluations were ordered by DCP&P local offices during the time period of July 2015 to March 2018. In total 2,124 (Private Providers = 1,790; RDTC = 334) forensic evaluations were sampled and requested for review which accounted for 21.8% of the total number of forensic evaluations ordered throughout the state for the time period listed.  1,643 forensic evaluations were reviewed by peer reviewers for the QI-Study, of those 1,321 (80.4%) evaluations were conducted by private providers; 322 (19.6%) were conducted by the RDTCs.

Quality Improvement Tool

The NJCC operationalized the Guidelines for Expert Evaluations in Child Abuse/Neglect Proceedings (Mental Health) and incorporated these operational definitions into the Quality Improvement Tool (QI-Tool) utilized by the peer reviewers for the QI-Study. The current version of the QI-Tool utilized by peer reviewers is Version 3, which was updated on July 26, 2018 before data collection activates began in the CARES Catchment Area. Updates and modifications were conducted, in consultation with the peer reviewers, after trends in the data that showed some questions needed an update in the operationalization, while other questions were not collecting usable data.

The QI Tool includes 155 questions, which assess forensic evaluations in three main areas: background, exploratory, guidelines:

• Background Questions: explores information pertaining to the background of the individual evaluated, the evaluation and the forensic evaluator.
• Exploratory Questions: explore trends and practices seen within evaluations however, these trends and practices are not within the Guidelines for Expert Evaluations.
• Guideline Questions: explores aspects of an evaluation which are tied directly to the operationalized aspects of the Guidelines for Expert Evaluations.
• Forensic Evaluation QI Tool Code Book v3.docx Download Forensic Evaluation QI Tool Code Book v3.docx