Articles from prior issues of The Advocate

January/February 2001

Tennessee’s Continuing Quality Education Program (CQEP)
by Elizabeth Pogue, Tennessee DDS with extensive input from Mary Lanigan, Chief Training Officer

How do we respond to the challenge of Disability Redesign, the expansion of complex issues, the flood of receipts and the dramatic decline in DDS Staff? How do we meet quality and production goals in the meantime? I am certain there are many innovative initiatives in practice throughout the DDS’s. The sharing of our combined experiences will help us to clarify which initiatives work.

Let me share what is working in Tennessee. The key element in our solution is ongoing training. The Agency management, with the help of the Quality Council identified areas where the Operations Staff (focused on, but not limited to examiners) needed additional training. These issues varied from software use, enhanced vocational training, PVT topics, special development, “refresher” training and foreign language lessons. As you might imagine the main barrier is time. Extensive time spent in training is time away from casework. Additional training would have to be “worked in” around an already heavy training schedule. The training staff teaches three 14-week initial examiner training classes in a year. In addition, Recon examiner classes, CDR classes and single issue topics (CDI, Drummond, Obesity, etc) are conducted on an as-needed basis. The creative solution that is both practical and flexible is our Continuing Quality Education Program (CQEP).

CQEP is designed to present numerous classes on virtually any topic requested by Operation Staff with minimal impact on the participant’s productivity. Topics for short (I hour) classes were solicited from various sources. Some were mandated from the Regional or Central Offices, but most come from management, the Quality council, the Quality Assurance Unit and examiners themselves. Blending the skills of experience staff members with the teaching expertise of the Training Staff is one of the strategies employed. Providing the participants with a wide range of training options reduced the frustration and proved to be most successful, especially in computer training where skill and comfort levels of staff vary greatly.

The Quality Assurance (QA) supervisor and other members of the QA unit presented classes on Reopening and Revision, Collateral Estoppel, and Failure to Keep CE issues. Future classes are planned for Writing and Effective PDN and STAT Blind issues. Each class is an hour in length and offered as many times as necessary to satisfy interest. Every instructor produces a Desk Reference. Training material must be created, edited, and constantly updated according to Federal guidelines to keep everything fresh and vital.

The computer trainers offered instruction to Operations Staff whenever changes or software updates occurred. They designed templates to improve the speed and clarity of development and to assist examiners when they propose assessments. They also provided training for all interested persons on how to access, save and manage RFC, MRFC and PRTF forms which are available on shared drive. The computer trainers also created specialized forms and a detailed “step by step” training manual covering procedures we use in VERSA and instructions on the STAT/REF, the DOT and the POMS.

The supervisor of Policy, Procedures, Quality, Training and Vocational (PPQTV) taught mandated classes such as Fraud Prevention, The Drummond and Denard Acquiescence Rulings and Obesity Listing Changes. He also taught classes in Enhanced Vocational Training using the Denver DOT.

In addition, trainees at the six-month mark are brought in for two days of refresher training. The Supervisory staff, QA staff and the trainees are asked to identify areas for review or trouble spots that need extra training. Once these suggestions are gathered from all sources, the Training Staff schedules the presentations and addresses the appropriate topics. There are a few issues that are favorites such as: transferability of skills, failure to keep CEs, the VERSA “TO DO” list and special development issues. Nevertheless, each refresher training session is unique to the needs of the participants.

The Medical Trainers brought short topics to the medical consulting staff. In particular they focus on listing changes, PUT issues and MIRS. This is in addition to their scheduled training of new examiners and new medical consultants. The Medical Trainers are also available for consultative or specific issues related to any of the Refresher Training topics.

Another challenge arose when our agency began to receive increasing numbers of Spanish-speaking claimants. To address this issue, the Training Staff contracted with a local community center to provide Spanish for Medical Professionals. So far 40 staff members took beginning Spanish and 12 participated in intermediate Spanish. These classes continue to meet weekly during the lunch hour for conversation development sessions.

The CQEP is working well for Tennessee DDS. Since the classes are voluntary and purposely short, they do not interfere significantly with production goals. Because the staff generates the topics, they have more interest and “ownership” in these classes as opposed to mandatory training. Even those examiners who did not attend the actual classes receive some of the training. Desk reference guides get copied and distributed, and students share their new knowledge back in their units. This indirect training often has more far-reaching positive affects on quality than the original classes.

Lastly, there are unexpected side effects. The promise of opportunities for ongoing, professional and personal development improved morale. The staff is now willing to ask for help from the Training Staff. And, the trainers, reacting to positive feedback, are inspired to be even more creative. The CQEP continues to constructively address ongoing quality issues.