12 minutes
A quality review that starts from the person See what changes in a quality review when the first source is the person rather than the file, and apply it to one review you take part in.
What you’ll be able to do Describe the difference between a file-first and a person-first quality review and apply the person-first sequence to one review you take part in. Compare the responses to this question and explain your choice: What is the most useful answer? Draft Person-first quality review for your work, including the person's answer, in their words, the domain they weight most, what the file explains. Sequence changes what you see A quality review that begins with the file looks for whether required things happened. Was the plan on time, were the visits logged, were the goals reviewed, was the incident reported. These are worth checking and they are checks on the service's activity. A reviewer who opens the file first will, without meaning to, read everything else through it: the person's comments become confirmation of the plan, and anything that does not fit becomes an anomaly.
A review that begins with the person asks a different first question: has your life moved in a direction you wanted, and if so or if not, what happened? The file is then read for explanation rather than confirmation. The same file, in this sequence, yields different findings, because the reviewer is looking for something else.
The person-first sequence Talk to the person before opening the file. Ask what a good year would have looked like and whether this was one.
Ask about one domain they weight highly: what changed, what did not, and what got in the way.
Now read the file. Look for what explains the person's answer: what the service did that helped, what it did that did not, and what it did not do.
Compare. Where the file's account and the person's account differ, that is a finding.
Name one thing to change in the service, one owner, and one date to look again.
Person-first quality review One page that starts from the person's answer and reads the file for explanation.
The person's answer, in their words What a good year would look like; whether this was one
The domain they weight most What changed; what got in the way
What the file explains What the service did that helped, did not help, or did not do
Where the accounts differ The finding
One change, one owner, one date Named person; a date to look again
Use it for one review this quarter and compare what it finds with the file-only method.
Browse and download only. Staff notes are not typed or saved on this page.
Download this published draft Change the first source What you can change You control the order in which a review gathers evidence. Putting the person first is a scheduling decision, and it changes everything the review finds.
What to watch for Do not let the review end in a score. A score is a way of saying that nothing in particular needs to change.
Your next step Set the next review's first appointment with the person, not the file.
Carry this forward A file-first review checks whether required things happened; a person-first review asks whether the person's life moved and then reads the file to find out why or why not.
The sequence matters: read the file first and you will look for confirmation of it; talk to the person first and you will read the file for explanation.
A person-first review ends with one thing to change in the service, not a compliance score.
A list of the person-first sequence, an artifact, a scenario decision and a knowledge check.
In your next quality review, talk to the person before opening the file and note what you would have missed.
Browse and download only. Course notes are not typed or saved on this page.
Reset this lesson
Previous lesson Back to course Carry this into practice The difference between a service delivered and a life changed, how to ask about outcomes in the person's terms, and what a quality review looks like when it starts from the person rather than the file.
Return to the experience: What did you notice or try, whose perspective informed it, and what would you keep or adjust?
Participation and course completion in this program do not count toward DHS-required training credits unless management, a director, or DHS leadership expressly approves an exception.
