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Quality Management Chart Review 2013-14

Quality Management Chart Review 2013-14. Pamela Casey, MS, RD June 24, 2014. HRSA National Monitoring Standards. Agency Expectations: Participate in Quality Management activities Compliance with HRSA service category definitions and local standards of care

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Quality Management Chart Review 2013-14

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  1. Quality ManagementChart Review 2013-14 Pamela Casey, MS, RD June 24, 2014

  2. HRSA National Monitoring Standards Agency Expectations: • Participate in Quality Management activities • Compliance with HRSA service category definitions and local standards of care • Collection and entering data for use in measuring performance

  3. Objectives • To utilize the data from the chart review to track the performance of the core services selected by the CCPC • Only a portion of the measures provided • To identify any areas for improvement • To provide the CCPC with the information needed to make funding decisions during the priority setting and resource allocation

  4. The process • Chart tool developed • Nurses hired • Schedule created for January and February • Data collected • Cleaned • Data input • Compiled in a report

  5. Review of CoreService Categories Ambulatory care Medical case management Oral health services Home and community-based health services Mental health services Substance use services Early Intervention Services (EIS)

  6. Ambulatory Care117 charts7 agencies

  7. Demographics

  8. At least 2 HIV provider visits during the period

  9. Primary Care in last 6 months

  10. CD4

  11. ARV

  12. Viral Load Suppression

  13. Cervical cancer/PAP screen

  14. Hepatitis-C Status Documented

  15. Tobacco

  16. Other Measures

  17. Highlights • Looking good • ARV • Pap smears • Documentation of dental care • Areas for improvement • Identify both viral load suppression and undetectable • Documentation of Hep-C status • Tobacco cessation counseling or referral • Document the connection with primary care to help identify those out of care

  18. Case Management13 sites170 charts

  19. Demographics

  20. Measures

  21. Assessment of needs

  22. Highlights • Looking good • Plan updates • Assessments • Areas for improvement • Risk reduction • Partner disclosure • Life skills/self-sufficiency

  23. Substance Use4 sites37 charts

  24. Demographics

  25. Care and Treatment

  26. Highlights • Looking good • In treatment at 3 months • Areas for improvement • In treatment at 6 months • medication adherence discussed: 54% in 2013-14, but 52% in 2011-12 chart review

  27. Mental Health7 sites61 charts

  28. Demographics

  29. Care and Treatment

  30. Highlights • Looking good • In care for 3 months • Assessed for substance use at the rate of 92% in 2013-14; 67% in 2011-12 • Areas for improvement • HIV Medication adherence (100% in 2012-13 to 57% in 2013-14)

  31. Oral Health6 sites 59 charts

  32. Demographics

  33. HRSA Performance Measures for Oral health

  34. Assessment

  35. Highlights • Looking good • Assessed for ARV • Periodontal screens • Areas for improvement • Oral health education • Medical history

  36. Home Health1 site10 charts

  37. Demographics

  38. Performance measures

  39. Early InterventionServices1 site10 charts

  40. Performance Measures

  41. Assessment for client needs

  42. Highlights • Looking good • Risk reduction • Assessment of substance abuse • Areas for improvement • Need for follow-up with connection to primary care • Assessed for basic needs

  43. Retention in Care

  44. Attempts made to reschedule appointments

  45. Eligibility Information

  46. Eligibility Requirements

  47. Evaluation of the Chart Review Good: • HIV specialist on staff • Helpful staff • Separate private, space provided • Flexibility with arranging extra time • Chart lay out was provided, data elements highlighted Not so good: • Accessibility of EHRs • Inconsistencies with client list pulled from ARIES • Signatures of clients not found on care plans • Documents located in several places Looking to the future: • Track the same data element year-to-year for trends • Collaborative effort on chart review

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