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Program Evaluation and Program Improvement. Kirsten Bennett MS RD LD November 8, 2013 Asthma Educator Institute Albuquerque, New Mexico. Scope of Practice. The NAECB definition of Asthma Educator includes:
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Program Evaluation and Program Improvement Kirsten Bennett MS RD LD November 8, 2013 Asthma Educator Institute Albuquerque, New Mexico
Scope of Practice • The NAECB definition of Asthma Educator includes: • “…. The educator monitors asthma education program outcomes and recommends modifications to improvequality and effectiveness.” • (NAECB Candidate Handbook, 2002, p. 1)
All improvement will require change but not all change will be an improvement! G. Langley et al The Improvement Guide. Jossey-Bass Publishers, San Francisco, 1996; xxi
Application of Quality Improvement (QI) Methodology in Asthma Education • How can we apply QI methodology and strategies to individual care of patients with asthma? • How can we apply QI methodology and strategies to healthcare systems to improve asthma care and outcomes?
Program implementation ends here Program implementation occurs here Four Types of Program Evaluation Impact Outcome Process Formative
3 Steps to Successful QI • Define the best care that can be provided in this setting • Identify the gap between current practice and best practice • Participate in closing that gap
QI is a Team Sport! F-O-C-U-S • Find a time to talk • Organize your team • Clarify processes • Understand variations • Select a process to improve
Identify the gap between current practice and best practice (or current care for the individual) • What is the baseline? • What are the potential causes of our baseline observations? • What are potential alternatives to current practice?
S3 : The Goals of QI (Individuals or Groups) • Simple operational change • Shortcycle evaluation of change • Sustainable after change is made
Applying QI to the Evaluation and Change Process • Formative • P (plan) • What do we need to do and for whom and by when? • Process • D (do) • How will we attempt this process and who specifically will be responsible for the various parts? • Outcome • S (study) • How will we measure what we are doing and what will we compare it to? • Impact • A (act) • Did this attempt at change or implementation meet our objective?
Where do you fit? • PDSA personality exercise
Let’s Practice • PDSA handouts • Flip Charts with Markers • Scenario 1: How will we know if the current asthma management plan documented for a patient (or population of patients) results in acceptable control (routinely and objectively? • Scenario 2: Reduce ED visits in a particular patient. • Scenario 3: Ensure every child with asthma has at least one planned visit for asthma management every 6 months.