Quality Program Evaluation: Using Results for QI Action Planning

1
Quality Program Evaluation Using Results for
QIAction Planning

• Nanette Brey Magnani, HIVQUAL Consultant
• NYSDOH AI Workshop
• December 19, 2008

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Workshop Outcomes

• Understand results of your programs
  Organizational Quality Assessment.
• Convert results of your Organizational Quality
  Assessment into a 2009 QI Action Plan for your
  organization.
• Complete an Organizational Quality Assessment
  (OQA) of participants own program. (for those
  who do not have a completed OQA)
• Gain a greater understanding of possible
  activities for improving QM Programs through
  participants exchange of their QI Action Plans.

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Agenda

• 930 Welcome and Introductions
• 945 Review Agenda and Workshop Outcomes.
• Overview of Evaluation Structure,
• Process, Outcome, Action Planning
• 1000 Using Results of Organizational
• Quality Assessment Tool
• (Participants bring documents Results of
• Orgl Quality Assessment Tool, QM
• Plans, QI Workplans/Action Plan,
• HIVQUAL results, QI Project results_

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Agenda contd.

• 1015 Small group work
• Task Group A Convert results of OA into a
• QI Action Plan for 2009
• Task Group B Understand and complete OA
• for your HIV Quality Management Program
• 1145 Report Back.
• 1220 Wrap-up, Q A, Evaluation
• 1230 Adjourn.

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A Framework for QM Program Evaluation

• Structure organizational structure, capacity
• Process activities
• Outcome
• Intermediary effectiveness of activities
• Short-term and long-term benefits and changes for
  patients

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Change Theory Spread

• Creating a New System
• Improvement
• Hold Gains
• Spread

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Assumptions

• The structure and process (activities) of QM
  Program can influence their effectiveness
  (outcome).
• In what ways, was the outcome (for good, or not)
  a result of how the QM program was set up
  (organized) and/or the way it was implemented
  (delivered)?

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Community Health Center - Structure
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Waterbury Hospital Accountability Structure -
Diagram

• Internal Communication

WHICH QM Committee
HIV Care Team
Consumer Advisory Group
Ryan White Program Director
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MDCH Ryan White Part D Quality Management
Accountability Chart - Structure
All subcontracted agencies minimally
participate in contractual Quality Improvement
activities.
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Organizational Quality Assessment Tool

• Purpose
• Components
• Creating Buy-in

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Structure

• A) Quality Structure
• Organizational structure
• Resources (staffing, program support staff)
• Leadership
• QM Plan, Annual QI Workplan (Action Plan)

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Structure contd

• E) Staff Involvement
• Engagement in staff in QI activities (process)
• Staff trained (capacity, structure)
• Attending training (process)
• H) Clinical Information System
• Information system in place

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Process and Structure

• B) Quality Planning
• Goals (process)
• Roles and responsibilities (structure)
• Annual QI Workplan (structure and process)

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Process contd

• D) Quality Improvement Activities
• Conduct QI Projects to improve quality of care
• Team approach (structure)
• Use of QI methodology, reporting, etc
• F) Consumer Involvement
• Structure in place to gain input (structure)
• Patient needs are assessed (process)
• Results incorporated into goals (outcome)
• Quality activity launched (process)

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Process contd

• G) Evaluation of Quality Program
• Review (process)
• Results used to plan ahead (outcome)

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Outcomes

• C) Quality Performance Measurement
• Selection of Quality Indicators (process)
• Measurement of quality of care (process)
• Results regularly reviewed and action taken
  (outcome)

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Gynecology Exams
Core Indicator
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Grantee-wide Vision
Strategic QM Plan (3-5 yrs)
QM Plan
Annual Goals
Annual QI Workplan (Action Plan)
Implementation
Annual Evaluation
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Action Planning (workplans)

• Key components
• Goal
• Activities
• Who responsible
• Timeline

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Example QM Program Workplan (Action Plan)Goal
Establish and implement an effective QM Program
to improve patient care.
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Example QI Action PlanGoal Improved quality
of patient care as measured by specific
performance indicators.
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Small Group A Exercise Convert results of OA
into an Action Plan for 2009

• Divide into groups of 5-6 members from a similar
  organization. You can have 2 members from the
  same program.
• Task Review results of your OA. Explain your
  programs results to group members including, if
  applicable, what improvements in each domain you
  made in 2008 to achieve current score. Using the
  Annual QI Action Plan, state goal(s) and list
  activities your program could implement to
  achieve the goals by the end of 2009.
• Supporting documents 2008 QM Plan Workplan.

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Small Group B Exercise Completing an
Organization Quality Assessment

• Divide into groups of 3-4 members from a similar
  organization. You can have 2 members from the
  same program.
• Task Complete an Organization Quality
  Assessment for your program. Use the other
  members in your group as resources to better
  understand the descriptors for the scoring. Then,
  explain your assessment to another group member.
• If time, complete Group A task.
• Supporting documents 2008 QM Plan Workplan.

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Report Out

• Group A recorders
• Write down the 3 common short term activities and
  3 long term activities.
• Select one of from each list that is the most
  important.
• Share with large group.

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Wrap up Summary, QA, Evaluation

• Thank you for joining us today.
• Have a wonderful HOLIDAY and Best Wishes for a
  Wonderful New Year ---- 2009!