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

2. Workshop Outcomes Understand results of your program’s 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.

3. Agenda 9:30 Welcome and Introductions 9:45 Review Agenda and Workshop Outcomes. Overview of Evaluation: Structure, Process, Outcome, Action Planning 10:00 Using Results of Organizational Quality Assessment Tool (Participants bring documents: Results of Org’l Quality Assessment Tool, QM Plans, QI Workplans/Action Plan, HIVQUAL results, QI Project results_

4. Agenda contd. 10:15 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 11:45 Report Back. 12:20 Wrap-up, Q & A, Evaluation 12:30 Adjourn.

5. 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

6. Change Theory: Spread Creating a New System Improvement Hold Gains Spread

7. 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)?

8. Chicago Health Center Board of Directors QI Committee of the Board Executive Leadership Team Staff QI Committee Leadership Team HIV Program Management Team Consumer Advisory Council HIV Program Staff Community Health Center - Structure

9. Waterbury Hospital Accountability Structure - Diagram Internal Communication WHICH QM Committee HIV Care Team Consumer Advisory Group Ryan White Program Director

10. MDCH – Ryan White Part D Quality Management Accountability Chart - Structure **All subcontracted agencies minimally participate in contractual Quality Improvement activities.

11. Organizational Quality Assessment Tool Purpose Components Creating Buy-in

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

13. 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

14. Process and Structure B) Quality Planning • Goals (process) • Roles and responsibilities (structure) • Annual QI Workplan (structure and process)

15. 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)

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

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

18. Gynecology Exams Core Indicator

19. Grantee-wide Vision Strategic QM Plan (3-5 yrs) QM Plan Annual Goals ***Annual QI Workplan (Action Plan) Implementation Annual Evaluation

20. Action Planning (workplans) Key components: • Goal • Activities • Who responsible • Timeline

21. Example: QM Program Workplan (Action Plan)Goal: Establish and implement an effective QM Program to improve patient care.

22. Example: QI Action PlanGoal: Improved quality of patient care as measured by specific performance indicators.

23. 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 program’s 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….

24. 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….

25. 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.

26. Wrap up: Summary, Q&A, Evaluation Thank you for joining us today. Have a wonderful HOLIDAY and Best Wishes for a Wonderful New Year ---- 2009!