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Introduction to QA, QI and Performance Management A Mark Durand PIHOA Quality and Health Information Coordinator December, 2011.

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Presentation on theme: "Introduction to QA, QI and Performance Management A Mark Durand PIHOA Quality and Health Information Coordinator December, 2011."— Presentation transcript:

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2 Introduction to QA, QI and Performance Management A Mark Durand PIHOA Quality and Health Information Coordinator December, 2011

3 Are you satisfied?

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5 QA/QI- Program Development by Site Key: 0 = No activity yet 1= Preliminary plan 2= Some progress 3= Program components installed 4= Program running Key: 0 = No activity yet 1= Preliminary plan 2= Some progress 3= Program components installed 4= Program running

6 QA & QI & PM

7 Church of God Seventh Day Adventist Congregational Catholic Orthodox Presbyterian Lutheran Baptist Church of Christ

8 Church of God Seventh Day Adventist Congregational Catholic Presbyterian Lutheran Baptist Church of Christ Quality Assurance Quality Improvement Continuous Quality Improvement Total Quality Management Performance Management Lean Six Sigma Baldridge Criteria

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10 QA & QI & PM

11 QA QI QI Tools

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13 Plan Objective Questions and predictions Plan to carry out the cycle (who, what, where, when) Plan for data collection Do Carry out the plan Document problems and unexpected observations Begin analysis of the data Track progress on work plan or Gantt Study Complete the data analysis Compare data to predictions Summarize lessons Data analysis / report Act What changes are to be made? Next cycle? Documentation of recommendations: report or minutes Learning and Improvement Cycle Logic model

14 Problem (Effect) 5 Why’s Technique Why?

15 Fishbone Diagram Lack of knowledge & skill in QI People Culture Methods Materials Resources

16 Cause and Effect Diagram for Low Use of HIV Screening: Poor HIV Testing Client Test Location Don’t see benefit Counseling Not Client Centered Not convenient Staff Not Respectful Fearful Not Offered Poor Experience Not Private Don’t Want Test

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18 QA QI QI Tools

19 Agency (Director) Units/Programs (Supervisors) Staff

20 Key Point! What is the job of a health worker? - Perform your duties to help your team to deliver services What is the job of your health units and programs? - Perform specific tasks or deliver specific services What is the job of your agency? - Support the work of its units and staff - Meet the needs of the population

21 Benchmark

22 Health WorkerUnit / Program Agency Question to answer How well does a health worker do his/her duties? How well does a unit or program do its tasks or services? How well does agency meet: - community needs? - needs of units/staff? Benchmark Job Description (Yearly Individual Performance Plan) Unit Standard Operating Procedures (QA) Goals& Objectives(QI) Strategic Plan (Goals & Objectives) Improvement Planning Yearly Individual Performance Plan - Corrective action plan (QA) - “P” in PDSA (QI) Performance Management Plan (using PDSA as needed) How to monitor Individual performance evaluation - QA Survey (scores) - PDSA (Set indicators- “P”; Measure results- “S”) Perf Management Plan Reports IncentivesRecognize, Merit $, Promote, “Perks” - Recognize team, celebrate, $$ (to team or individuals) - Budget, grants, Promotion/demotion

23 PM QI Tools Agency or jurisdiction level Examples: 1. Nursing shortage Low $ collections 2. Access to care NCD epidemic

24 Key Point! What is the job of a health worker? - Perform your duties to help your team to deliver services What is the job of your health units and programs? - Perform specific tasks or deliver specific services What is the job of your agency? - Support the work of its units and staff - Meet the needs of the population

25 Are we satisfied? Current situation? Needs Assessment What to do? Goals, strategies & objectives Assure successPerformance Improvement System

26 Level 1: “reactive” response Level 2: partial response Level 3: performance management Example: Situation: Nursing shortage

27 Needs assessment: Not done Goal: Not clear Objective: Not clear Strategy: 1. Train practical nurses whenever shortage becomes acute 2. Hire nurses off-island “reactive” response:

28 Situation: Nursing shortage Needs assessment: Done Goal: A supply of high-quality, local nurses Objective: Not clear Strategy: 1. Recruit nurses to study off-island 2. Establish community college nursing pgm 2. Hire expat nurses Partial response:

29 Situation: Nursing shortage Needs assessment: Done Goal: An adequate supply of high-quality, local nurses Objective: 100% of ward nurses should have formal college nursing certificates or degrees by 2015 Strategy: Partnership between hospital and comm college - define target group of nurses - financing - employment policies - work-study scheduling, transport, classroom site Proactive response:

30 Are we satisfied? Current situation? Needs Assessment What to do? Goals, strategies & objectives Assure successPerformance Improvement System

31  Community Health Assessment  Community Health Improvement Plan  Agency Strategic Plan  Performance Improvement System (for 10 essential public health services) Assessment Monitor health status Investigate health problems Evaluate personal and population-based health services Policy Development To support individual and community health efforts Enforce laws and regulations that protect health. Research for solutions to health problems Assurance Link people to needed personal health services Assure a competent health care workforce Inform people about health issues Mobilize partnerships to solve health problems

32 Bureaus/Sections reponsible: DOMAIN 1: Conduct and disseminate assessments focused on population health status and public health issues facing the community Standard 1.1: Participate in or conduct a collaborative process resulting in a comprehensive community health assessment S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state S Complete a state level community health assessment A Ensure that the community health assessment is accessible to agencies, organizations and the general public Standard 1.2: Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population A Maintain a surveillance system for receiving reports 24/7 in order to identify health problems, public health threats and environmental public health hazards A Communicate with surveillance sites at least annually A Collect additional primary and secondary data on population health status Public Health Accreditation Board Standards and Measures

33 PH Accreditation Orientation (web-based):

34 Type of measure (i.e., output or outcome measure) Format of measure (e.g., Yes/No, count, proportion, time-based, other) Measurement specifications (e.g., start/stop time, numerator/denominator, what is being counted) Baseline value and associated date(s) Target value and associated date(s) CDC Performance Management Reporting Tool

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36 Quiz: Is it QA-QI-PM? (or is it a “blind improvement attempt”?)

37 Behavioral health unit offers substance abuse counseling training to DHS staff. “Blind improvement attempt”

38 Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey. QA-QI-PM

39 Chief nurse arranges transportation to help night shift nurses get to work. “Blind improvement attempt”

40 Nursing team develops plan to help decrease absenteeism rate on medical ward QA-QI-PM (if impact is measured)

41 Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic “Blind improvement attempt”

42 DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10% from current rate of 67% QA-QI-PM (if follow-up measurment is done)

43 Nursing Supervisor requires all nursing unit supervisors to take on- line QI course, and follows-up until all supervisors on her list have completed QA-QI-PM

44 DHS hosts training workshop to train doctors, nurses and health assistants to apply new NCD treatment guidelines “Blind Improvement Attempt”

45 HRH Committee develops strategy for recruiting 60 new students into COM- FSM nursing program by QA-QI-PM

46 A Mark Durand


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