Tools,
Forms and Survey Instruments
This page will feature
tools that member organizations are willing to share with the public. Send
tools in any of the following electronic formats: MS Word, Excel, PowerPoint,
Access, WordPerfect, or Adobe Acrobat. Email your tools to: brian@loebigink.com.
| Date Posted | Tool Title/Description | Download Format | Organization and Contact Person |
| 11/17/04 | Disaster Response and Management Guide - 36 pages; This guide was developed by a team at Lutheran Children and Family Service for the organization, Brian Loebig, MBA | MS Word 97 |
Lutheran Children and Family Service Philadelphia, PA Brian J. Loebig, VP Quality Improvement |
| 4/26/04 | Statistics as a Tool - 29 slides; A Presentation on statistics for a QLN training event developed by Bernie Newman, Ph.D. | PowerPoint (.77 Kb) |
Temple University, School of Social Work Bernie Newman, Professor |
| 5/8/03 | Doing It Right the First Time - 120 pages; this is a complete QI manual written and published by Fotena Zirps, Ph.D. and offered for distribution exclusively for the Quality Leaders Network | Win Zip (3.8 Mb) |
IQAA Books Fotena Zirps, Author and Owner |
| 10/1/02 | HIPPA Assessment Questions - 2 pages; this assessment questionnaire is being used by the agency to help determine which programs may be covered by the Health Insurance Privacy and Portability Act (HIPPA). | MS Word 97 |
Lutheran Children and Family Service Philadelphia, PA Joan Myers, Corporate Compliance Officer, Brian Loebig, VP Quality Improvement |
| 4/4/02 | Framework for Quality Assurance in Child Welfare - 82 pages; the framework includes the broad elements of QA activities all agencies should consider in creating new or energizing existing QA systems. | Adobe.pdf |
National Child Welfare Resource Center for Organizational
Improvement Edmund S. Muskie School of Public Service Univ. of Southern Maine, Portland, Maine Peter Watson, Associate Director |
| 1/15/02 | WI Outcomes Profile for Women's Substance Abuse Treatment Grants - 2 page checklist format with interview guide | MS Word 97 |
WI Dept. of Health and Family Services, Bureau of
Substance Abuse Services, Madison, WI. Mike Quirke, Program Evaluation Coordinator |
| 1/15/02 | Case Record Review Process - Case record review flow chart (Foster Care Program) | MS Word 97 |
Lutheran Children and Family Service, Inc.,
Philadelphia, PA Brian Loebig, VP QI |
| 10/19/01 | Employee Survey: Napa County Health & Human Services Performance Assessment | MS Word 6.0/95 |
Napa County Health and Human
Services Karl Porter, Project Manager, Napa, CA |
| 10/16/01 | Assessing Outcomes in Child Welfare Services: Principles, Concepts and a Framework of Core Indicators | Adobe.pdf |
The Casey Outcomes and Decision
Making Project and the American Humane Assn. Peter J. Pecora, Ph.D., Senior Director-Research Services, Casey Family Programs, Seattle, WA |
| 10/7/01 | Utilization Review (UR) Meeting
Report and Admin UR Meeting Report |
- MS
Word 97 - MS Word 97 |
NBA Colo. Christian Home Tennyson
Ctr for Children and Families, Denver, CO Stacy Woolley, Director of Quality Management |
| 9/27/01 | Quality Improvement Plan - Comprehensive agency-wide QI plan (16 pages MS Word) and Quality Structure Org Chart (Org Chart in MS Excel) | - MS
Word 6.0/95 - MS Excel 97 |
FamiliesFirst, Inc., Davis, CA Louise Angermann, Quality Improvement Manager |
| 9/13/01 | Customer Survey - Post card type survey for adults, adolescents, foster parents, and refugees | MS Word 6.0/95 |
Lutheran Children and Family Service, Inc., Philadelphia, PA Brian Loebig, VP QI |
| 9/4/01 | Case Record Review Form - Foster Child and Parent review form covering state, county, COA and agency requirements. | MS Word 6.0/95 |
Lutheran Children and Family Service, Inc., Philadelphia, PA Brian Loebig, VP QI |
| 8/13/01 | Incident/Accident Report - This document template is used for reporting incidents or accidents involving staff or clients. | MS Word 6.0/95 |
Youth Service, Inc.,
Philadelphia, PA Gwen Bailey-Rahman, Associate Director |
| 8/13/01 | Employee Survey - Annual satisfaction survey instrument for all levels of employees. | MS Word 6.0/95 |
Lutheran Children and Family Service, Inc., Philadelphia, PA Brian Loebig, VP QI |
