Measurement of Identification, Services, and Outcomes.
Accurate qualitative and quantitative identification of types and severity of abuse determine the need for service delivery and amelioration of abuse. The ability to measure services and outcomes allows “closing the loop” on what was needed, what was done, and how well it turned out. Caseworkers and APS program can feel more confident that in documenting with the ISO Matrix, they have research-supported reasons why they ask certain questions to support their disposition on an investigation. If anything was not covered, they can still provide additional case notes.
Objective Evidence Gathering.
Standardized measures provide objective evidence and depict the big picture about the case, then decisions on substantiation or service referral/delivery are based on reported facts, instead of one’s opinions. Supervisors know what they are looking for in reports and can monitor how individual caseworkers are using the system. For example, a sexual abuse case was successfully prosecuted using the ISO Matrix to ask some personal and difficult questions to victim. Correlations between different types of abuse were also calculated based on the ISO Matrix data, so caseworkers would pay attention to the types of abuse that often co-occur. Outliers in the data can help find errors and reveal idiosyncratic practices with data to inform them. Caseworkers can use the system to give feedback about errors or bugs and ways to improve it.
Standards of Best Practices.
Having standardized measures enables setting standards of best practices. This facilitates communication within and between APS agencies. An obvious benefit is the new caseworkers learn from the standardized practices that everyone else is using and can quickly ask questions and come up to speed on those practices, e.g., how to interview the alleged abuser. New caseworkers can use the ISO Matrix as a built-in guidance on conducting an investigation interview to cover all the bases. The ISO Matrix gives a clear, evidence-based directive on what questions should be asked, and that it may be the most comprehensive risk assessment structure in practice at this point in time. Each question has purpose, and it was tested by their peers. The caseworkers have research-supported reasons why they are asking certain questions to support their disposition on an investigation. Peace of mind can be valuable for a caseworker who wants to ensure the best outcome for their clients – Human trafficking: Improving victim identification and service provision these curated questions can help with that.. Based on counties’ feedback, interestingly, standardization helps with faster and clearer documentation!
Promoting client’s self-determination and engagement.
The ISO Matrix is designed to ask questions directly of clients with the understanding that the caseworkers must decide the final answers based on complete investigative information. This focus on the client involves the clients in providing answers to questions that result in a severity score principally determined by client input. This along with client involvement in service planning derives from the philosophy that the determination of abuse and its remediation primarily resides with the clients themselves. This philosophy is designed to promote service engagement and self-activation in recovery. Of course, caseworker judgment must prevail in cases of cognitive challenges, aphasia, fear of abuser retaliation and so on.
The ability to estimate outcomes provides evidence to support ongoing and increasing funding for APS services. For example, it enables the program director to demonstrate objective effectiveness since ISO Matrix scores are based on client input as well as input from collaterals. These inputs are interpreted by caseworkers, but they all use the same measuring stick, i.e., ISO Matrix, to gather the data. Not only caseworkers benefit from having standards of best practice, but supervisors can assist caseworkers during case consults, supervision, and in providing equal services to victims based on documented evidence across time between various cases. Since we now know how the data are gathered, we can work to improve that process and believe in it. Training can be more specific and less vague.
Professionalizing the Field.
The creation of standards of best practice can professionalize the field, e.g., promote certification to improve the work force. Professionalizing the field involves having a documented body of knowledge that is accepted to be best practice in that field. One way to achieve evidence to support the validity of that body of knowledge is through empirical research. The ISO Matrix provides the measures that are needed to conduct research, program evaluation and improvement. It also sets out the major topics and tasks that should be undertaken in fieldwork. These can now be studied and challenged, and these studies form a scientific body of evidence that creates a professional field like medicine or engineering. This body of scientific knowledge can be taught with greater certitude and forms the basis for certification. Certification provides a standard of professionalism and forms a basis for obtaining jobs and promotions.
Program Quality Improvement.
Having measures enables the setting of benchmarks to manage program improvement. How is the program changing over time? How can we document improvement or decline? For example, comparing types of services delivered over time may reveal types of services that are more effective or more available for certain types of cases. Taking San Francisco APS as an example, implementing the ISO matrix has served as one of the primary catalysts for the redesign of their case management practice procedures. These revisions, as well as the use of validated assessment tools, have helped caseworkers to examine and validate their decisions regarding the substantiation and elimination of abuse. By evaluating the case process starting with the ISO matrix risk assessment, there has been deduplication of unnecessary tasks and more standardization of documentation and activities related to serving clients. Following this evaluation of case procedures, there is more clarity in the case closure process.
Theory-Testing for Best Interventions and Cost-Effectiveness.
Standardized measurement enables quantitative testing of theories of best practice. For example, does an Elder Abuse Forensic Center help to enhance service provision as measured by ISO Matrix? Does it enhance coordination and cooperation among service providers to improve service provision and promote improved outcomes as measured by ISO Matrix? What are the most effective agencies and how can we learn from them? What are the most effective referrals? What practices are most cost-effective? Why have clients/victims been reported back to APS for the same type of abuse or new issues, and how serious compared with the last report? Can some procedures, e.g., automated reporting of scores, save time for caseworkers and supervisors? Are standardized reports easier and quicker to read while also being more reliable?
[Last updated on 2/24/2020]