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Developing and Implementing an Evaluation Plan for the Houston EMA

Developing and Implementing an Evaluation Plan for the Houston EMA. Developing an Evaluation Plan. In FY 2000, the Ryan White Planning Council requested that HIV Services coordinate outcomes development, to be implemented in FY 2001

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Developing and Implementing an Evaluation Plan for the Houston EMA

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  1. Developing and Implementing an Evaluation Plan for theHouston EMA

  2. Developing an Evaluation Plan • In FY 2000, the Ryan White Planning Council requested that HIV Services coordinate outcomes development, to be implemented in FY 2001 • From the beginning, the CPCDMS data system was considered to be the foundation upon which the evaluation plan would be built • CPCDMS = Centralized Patient Care Data Management System, a real-time client-level data system that has been operational since June 2000

  3. Developing an Evaluation Plan • In fall 2000, HIV Services conducted an orientation for service providers, RWPC members and consumers • This meeting defined the basic elements of an outcomes evaluation plan according to HRSA and United Way outcomes development methodology

  4. Developing an Evaluation Plan • HIV Services then facilitated work groups to select the outcomes and indicators to be measured for 25 Title I service categories • Participants included providers, consumers and RWPC members • Reference materials included outcomes from other EMAs, HRSA guidances and accepted industry outcomes • Work groups defined each service’s inputs, activities and outputs to then determine its initial, intermediate and long-term outcomes

  5. Developing an Evaluation Plan • Each group worked from a template that outlined four categories of outcomes: • Health Example - Decreased or maintained viral loads • Quality of life Example - Increased ability to perform Activities of Daily Living • Cost-effectiveness Example - Fewer days of HIV-related hospitalization • Knowledge, attitudes and practices (KAP) Example - Entrance into medical care, increased adherence to HAART

  6. Developing an Evaluation Plan • Work groups selected data collection methods for each outcome and indicator, including: • The CPCDMS • Client surveys • Provider assessments

  7. Developing an Evaluation Plan • The RWPC approved the outcomes in January 2001 • The Quality Assurance Committee of the RWPC oversees evaluation activities • The outcome measures are reviewed and revised each fiscal year • Each work group reconvenes • The RWPC approves the revised outcomes each year

  8. Data Collection • Through registrations, service encounters and medical updates, the CPCDMS collects the following data used in outcomes analysis: • Demographics • CD4 counts and viral loads • Stage of illness diagnoses • Co-morbidities • Opportunistic infections • Mortality • Health and support service utilization • Provider assessments (BIA, GAF, etc.)

  9. Data Collection • The CPCDMS cannot provide information about • Quality of life • Cost-effectiveness • Except service utilization • Knowledge, attitudes, and practices • Except service utilization • ER visits and hospital admissions • Client surveys collect this information

  10. Data Collection • Client Surveys • Each survey was pilot-tested at at least one agency • Virtually all surveys are less than one page in length, most are four questions or less • Clients do not have to provide any demographic information on the survey forms

  11. Data Collection • Survey Administration • FY 2001 • Clients wrote their unique code on the survey form and circled their responses • Providers entered survey data into Excel • HIV Services stored data in an Access database • FY 2002 • Surveys are printed from the CPCDMS with the unique code bar-coded; clients bubble in responses • The bar-coded surveys are scanned at HIV Services and stored in a SQL database, which is linked to CPCDMS data

  12. Implementation • Prior to the beginning of the fiscal year, agencies receive technical assistance on outcomes • Survey administration • Data submission • Agencies are contractually obligated to participated in outcomes activities • Reimbursements can be withheld if data is not submitted on time

  13. Implementation • Data collection began March 1st, 2001 • HIV Services analyzes outcomes data on a quarterly basis • Each agency and the RWPC receives results • Agencies receive both agency-specific and cross-category results • The RWPC receives only cross-category results, although they may request agency-specific reports • The RWPC uses the data in their planning processes

  14. For More Information… Elizabeth Love, MPH Project Coordinator – Evaluation and Quality Management HIV Services Harris County Public Health and Environmental Services 2223 West Loop South, Room 417 Houston, TX 77027 (713) 439-6041 elove@hd.co.harris.tx.us

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