Home > Working together for better quality in drugs services.

Pike, Brigid (2011) Working together for better quality in drugs services. Drugnet Ireland, Issue 37, Spring 2011, pp. 13-14.

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To help ensure drug treatment and rehabilitation outcomes are achieved and to maintain a high standard of client safety, the National Drugs Strategy 2009–2016 calls for the introduction of ‘a clinical and organisational governance framework for all treatment and rehabilitation services in Ireland’ (Action 45).

In collaboration with the HSE’s national office of social inclusion, the Progression Routes Initiative (PRI), a voluntary agency co-located with the Ana Liffey Drug Project in North Inner-City Dublin, has developed a project to support community and voluntary organisations and groups to implement effective policies and develop services with the aim of assessing for themselves to what extent they meet the Quality Standards in Alcohol and Drugs Services (QuADS).1
PRI supported 30 services in 2010, and is taking on another 70 services in local and regional drugs task force areas in 2011. The work is funded by the HSE and the North Inner City Drugs Task Force.  While the supports are provided free of charge, management and staff in the participating services have spent on average three hours a week over the course of 2010 implementing the process.
PRI works on the principle that quality is a journey, not a destination, a continuing process of self-reflection, change and renewal, and individual organisations and groups are invited to set their own pace in relation to assessing their service as ‘QuADS compliant’. PRI points out that payback starts almost immediately as organisations that begin to work within a sound clinical and governance framework start to provide a more efficient and effective service in a more economic, and enjoyable, manner. 
Becoming QuADS compliant, with the support of PRI, occurs in two phases.
1.    Self-review: Each organisationworks through the QuADS framework, reviewing their policies and procedures against the template policies provided.  The following supports are provided for this self-review and organisational change process:
o   A ‘policy library’ is available on line. It contains more than 75 template policies, covering governance, human resources, service provision policies, service-user-related policies, and case management and care planning. These policies have been extensively researched and had editorial input from industry leaders from the health and commercial sectors. Participants are advised to adapt these policies to their own needs through an internal consultation process involving staff and service users.
o   Service-specific facilitation and policy development is available on request. It is an effective way of engaging staff and management in the development of policies. Service-specific training modules are also available.
o   Directors seminars for all participating organisations are held approximately every quarter to facilitate interagency best-practice learning.
2.    Peer review: After completion of the self-review phase and the integration of quality standards and procedures into all aspects of operations,an organisation or group may request a peer review. Peer review is a relatively new way of promoting and supporting organisational and sectoral development. It has been used within therapeutic communities across Europe and also in the youth services sector. In the QuADS context it will involve two organisations from within the QuADS network auditing and evaluating the work of another organisation against a standardised framework, using a specially developed IT system. Over two days these reviewers will meet with service users, staff and managers and complete a policy and file audit. The reviewers will draft a comprehensive report that will assist the organisation under review to further improve its policies, systems and procedures. The reviewers will also present an overview of their findings to a representative group of service users, staff and management, in order to ensure a cohesive and transparent process and to contribute to collective ownership of the QuADS approach.
The first 30 services to participate in the PRI QuADS support project, the ‘2010 Group’, are currently completing Phase 1 of the process. A working group drawn from the 2010 Group is now developing terms of reference for how peer review will work in Ireland. The group is aiming, with support from PRI, to trial the Phase 2 peer review process in 2011.
Since its inception, the QuADS support project has seen a considerable rise in demand for participation from services around the country and, as a result, there is a waiting list for participation in 2012.
PRI was set up five years ago by Dublin’s North Inner City Local Drugs Task Force. Its purpose is ‘to connect interagency service delivery with national policy, promoting good practice through pilot initiatives and the provision of practical organisational supports’. The QuADS support project is just one of its projects. Others have included a community detox pilot and a case management pilot. These two pilots resulted in the development of protocols to enhance inter-agency working, and the production of a case management guidebook, jointly published with the Homeless Agency.


Contacting Progression Routes
Service providers seeking information on participating in a future round of the ‘QuADS compliance’ project should contact staff at Progression Routes.
Caroline Gardner                                   Aoife Dermody / Martin Quigley
Manager                                                Development Workers
pri@aldp.ie                                            aoife.dermody@aldp.ie / martin.quigley@aldp.ie
01 878 6899                                          01 878 6899
Progression Routes has uploaded all its information and resources, including the QuADS policy library http://www.drugs.ie/resources/quads/policy_library/ 
1.  For more information on QuADS, see the Report of the HSE Working Group examining Quality & Standards for Addiction Services.

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