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Aug 26, 2008 Clemens Steinbock, MBA Director, National Quality Center

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1 Aug 26, 2008 Clemens Steinbock, MBA Director, National Quality Center
Quality Institute Session 1 What is Quality Improvement? What are the Quality Expectations from HAB? Aug 26, 2008 Clemens Steinbock, MBA Director, National Quality Center

2 Agenda - Opening Remarks - Overview and Introduction
- Quiz – Group Activity - Principles of Quality Improvement - Scenario – Group Activity - HAB Expectations on Quality - QI Resources - Evaluations and Wrap-up

3 “How can you make this topic entertaining and keep everyone from falling asleep?”

4 What are my options? Use humor

5 What are my options? Use my kids

6 What are my options? or Use the audience… via the Audience Response System

7 Quiz

8 1) What does CQI stand for?
Community Quality Initiative Case Management Quality Ideas Continuous Quality Improvement Circular Quantum Invention

9 2) Why does Quality Improvement become increasingly important in health care?
Quality Improvement has been proven to be successful Increasing requirements by regulatory agencies Increasing accountability by programs for the quality of services All of the above

10 3) What is the main difference between Quality Assurance and Quality Improvement?
Quality Assurance uses mainly a team approach Quality Improvement focuses on statistical outliers for improvements Quality Assurance and Quality Improvement is practically the same None of the above

11 4) What is the most important principle for Quality Improvement
4) What is the most important principle for Quality Improvement? Quality Improvement focuses on… Individual performers Routine measurement of performance Training of providers System’s issues

12 5) Which of the following statement by HAB is INCORRECT?
QM programs need to look beyond clinical services to consider both supportive services and outcomes QM programs assess the extent to which HIV health services are consistent with the most recent Public Health Service guidelines The primary focus of the QM program is on performance measurement to assess clinical and non-clinical services Quality is the degree to which a health or social support service meets or exceeds established professional standards and user expectations

13 6) HAB describes the following characteristics of Quality Management Programs. Which ones are CORRECT? Be a systematic process with identified leadership, accountability and dedicated resources Use data and measurable outcomes to determine progress toward relevant, evidenced-based benchmarks Focus on linkages, efficiencies and client expectations in addressing outcome improvement Ensure that data are fed back into the quality improvement process to assure that goals are accomplished All of the above None of the above

14 7) The following performance data report is presented: PPD 95%, GYN 85%, and PCP Prophylaxis 55%. You advise the program to continue to measure… only PCP Prophylaxis GYN and PCP Prophylaxis All three indicators

15 8) The results of an adherence QI project are presented after 10 months of work, improving the rate to 98% and it was kept between 95%-100% for the last 4 months. You advise the program to… Discontinue routine measurements Switch to quarterly measurements Keep monthly measurements

16 9) Due to the high rate of Mental Health screening (95%), the QI team stopped meeting but continued to measure the rate monthly. Recently the score declined. When should the MH QI team to re-start? 90% 80% 70%

17 Couple more questions…

18 What is your professional background?
Clinical Provider (MD, NP, PA) Nurse Case Manager/Social Worker Administrator Other 10

19 How do you rate your own quality improvement knowledge?
Novice Beginner Intermediate Proficient Expert 10

20 How do you rate your HIV Quality Management Program?
Not existing Beginning Sufficient Good Excellent 10

21 Quality Improvement Principles
Clemens Steinbock, MBA NationalQualityCenter.org 86,408 PLWA – reported in the 8 states At least 43,000 PLHIV – estimated TOTAL POTENTIAL IMPACT: IMPROVING THE QUALITY OF CARE FOR 129,000 PLHIV/AIDS -- >10% of PLHIV/AIDS in United States

22 Success is achieved through meeting the needs of those we serve.

23 Most problems are found in processes, not in people.

24 Do not reinvent the wheel – Learn from best practices.

25 Learn through small, incremental changes to achieve continual improvements.

26 Actions are based upon accurate and measured data.

27 Infrastructure enhances systematic implementation of improvement activities.

28 Set Priorities and Communicate clearly

29 Balance between Data Collection and Quality Improvement Activities
Infrastructure

30 ‘QI is not QA’ Motivation Means Focus Responsibility Quality Assurance
Quality Improvement Motivation Measuring compliance with standards Continuously improving processes to meet standards Means Inspection Prevention Focus Individuals, “bad apples” Processes and Systems Responsibility Few All

31 Three Faces of Quality Improvement
Aspect Improvement Accountability (Accreditation) Clinical Research Aim Improvement of care Comparison, choice, reassurance, spur for change New knowledge Test observability Test observable No test, evaluate current performance Test blinded Sample size “Just enough” data, small sequential samples Obtain 100% of available, relevant, data “Just in case” data Testing strategy Sequential tests No tests One large test Solberg, Mosser, and McDonald, Journal on Quality Improvement. March 1997, Vol.23, No. 3.

32 HAB’s Working Definition of Quality
“Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Institute of Medicine. Medicare: A Strategy for Quality Assurance. Vol. 1. (1990)

33 In 1601, James Lancaster successfully conducted an experiment to illustrate the effectiveness of lemon juice to prevent scurvy. When did the British Navy adopt this treatment? 1602 1689 1757 1796 1865 British Board of Trade adopted the policy for all ships in the merchant marine – 264 Years later

34 Treatment of Scurvy Stephen J. Bown - Scurvy: How a Surgeon, a Mariner, and a Gentleman Solved the Greatest Medical Mystery of the Age of Sail; St. Martin's Press, 2004 In 1601 lemon juice, as a protective against scurvy, is recorded by James Lancaster. In 1612, Woodall recommended citrus fruit for protection against scurvy on sea voyages. In 1753 James Lind published A Treatise on the Scurvy which portrays his experiment on-board the ship Salisbury in 1747. From 1772 to 1775 sailors on historic voyages with Captain James Cook remained free from scurvy. In 1796 lemon juice was officially introduced in the British Navy as a prophylactic against scurvy. In 1865 British Board of Trade adopted the policy for the merchant marine.

35 How long did the NIH take to recommend the treatment of ulcer as suggested by Dr. Marshall in his 1984 Lancet Article? 2 years 5 years 10 years 20 years 1865 British Board of Trade adopted the policy for all ships in the merchant marine – 264 Years later

36 Treatment of Ulcer – Marshall
Timetable: 1979: Dr. Robin Warren, pathologist at Royal Perth Hospital, Australia found bacteria in stomach of patients 1981: Dr. Barry Marshall starts residency 1982: Marshall cultivates bacteria: Helicobacter pylori, 100% in Duodenal Ulcer and 77% in Gastric Ulcer 1984: first publication in Lancet; presents treatment of ulcer with common antibioticum 1994: National Institute of Health recommends treatment of ulcer as suggested by Dr. Marshall Conclusio: Too long to adapt proven concept - how can we adapt existing knowledge faster in daily actvities New ideas come from outsiders ‘Early Adopter’ Diffusion of Innovation Everett Rogers B) Neugeborenenstation in Honulu, Hawaii hat jährlich $120,000 Dollar für Schutzmasken, Plastik Handschuhe usw. ausgegeben. Nach 13 Studien wurde dort eine 14. Studie durchgeführt mit dem selben Ergebnis: es gibt keinen messbaren Unterschied der Ansteckungsrate zwischen der Vergabe von Schutzkleidern an Besuchern und der Nichtvergabe. C) CQI Team: billinf Team, six months still trying to find causes, did not start to change things around. HAND OUTS

37 In a recent article in the Journal of Quality Improvement 92 QI projects were compared. What was the timeframe from problem identification to completion of first pilot? 23 days 60 days 397 days 504 days 1865 British Board of Trade adopted the policy for all ships in the merchant marine – 264 Years later

38 Survey of 92 Quality Improvement Projects in Journal of Quality Improvement
Alemi F, Safaie F, Neuhauser D. “A Survey of 92 Quality Improvement Projects.” Journal of Quality Improvement 2001, 27(11): 504 days from problem identification to completion of first pilot 397 days from first team meeting to the end of first cycle 75 days to describe current situation in flowchart 62 days for data collection if change was improvement

39 How can we accelerate change and improvements in HIV programs?
Model for Improvement How can we accelerate change and improvements in HIV programs?

40 Model for Improvement Act Plan Study Do Model for Improvement
What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Model for Improvement Act Plan Study Do MFI model for Improvement How many have heard? Elegantly simple model that is useful … 3 questions plus the PDSA cycle Go over 3 questions and plan do study act ; pdsa

41 What are we trying to accomplish?
Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Why this question is important … highly corelated with success of a team ..

42 that a change is an improvement?
Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? What is the second question … how will we know? Why is this important ….

43 What change can we make that will result in improvement?
Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? So what is the third question? The changes that you make should align with your aim and measures… Where do they come from ? IHI change packages… chanes with a pedigree… have a high degree of belief they willwork .. Have worked .. Ideas in the op doc.. Op Doc.. Each other..

44 The PDSA cycle for learning and improvement
Act Plan Objective Questions and predictions (why) Plan to carry out the cycle (who, what, where, when) What changes are to be made? Next cycle? Study Do Complete the analysis of the data Compare data to predictions Summarize what was learned Carry out the plan Document problems and unexpected observations Begin analysis of the data

45 PDSA Cycle to incorporate the use of a new CM form
Improve Access to HIV Primary Care D S P A DATA A P S D Cycle 1E: Implement and monitor the standards D S P A Cycle 1D: Revise and test tool with all clients for one week A P S D Cycle 1C: Present refined tool to all 3 case managers and document feedback A P S D Introduce new CM Intake/ Assessment Form Cycle 1B: Revise tool and test with Karl’s clients next Monday Cycle 1A: Adapt new CM form and test with one of Joanne’s patients

46 Tips for PDSA Cycles “What change could you implement by next Tuesday?” Use the “Rule of 1”: 1 facility 1 office 1 provider 1 patient We’ve learned: Keep the first test small. Remember Dr. Smith and her 35-minute screening tool. Give yourself a chance to even to fail in this first test. Sometimes you learn the most from trying something that really doesn’t work. A common question to those starting their first PDSA cycle is: what change can you implement by next Tuesday? This question forces you to think small by reducing the sample size (‘just a few records’) and decreasing the implementation timetable (‘within a few days’) to a minimum. One way to help you and your colleagues “keep it small” is to remember the Rule of 1. Design the first test for one facility, one office, one provider or one patient. See what happens, act on that knowledge, and then scale-up the test.

47 Useful, not perfect, data Use “huddles” to report
Tips for PDSA Cycles Volunteers at first Useful, not perfect, data Use “huddles” to report Learn from others (‘Steal shamelessly, Share senselessly’) Here are three more important pointers for success: Start out with your friends. Don’t try to convince the skeptics until you have proof. To get the proof, use volunteers – people who are interested in doing things differently. This isn’t a randomized clinical trial. It’s a test. You don’t need double-blind data, you need information about how to make things work. Whether Dr. Smith’s test took 34.3 minutes or minutes doesn’t matter. The point is that it took about 35 minutes, and that was way too long. Scheduling a formal meeting will take at least a week – pretty silly to do that to discuss the results of a one-day test. Grab people when you can, share information as it comes up. Dr. Smith could find Sally after the patient visit on Thursday morning and say, “Sally, that tool took 35 minutes, this will never work.” Sally might say, “Wow, you’re right. Joan and I found other tools, let me get her and we’ll come up with some others that might be better to try next.” The important thing is to keep moving forward, because…

48 References Moen, Ronald, Thomas Nolan; “Process Improvement” Quality Progress, 1987, p62 Langley, Gerald, Kevin Nolan and Thomas Nolan; “The Foundation of Improvement,” Quality Progress, June 1994, p. 81 Langley, Gerald, Kevin Nolan, Thomas Nolan, Cliff Norman, and Lloyd Provost; “The Improvement Guide” San Francisco, CA; Jossey-Bass, 1996 Nolan, Kevin; “ASQs Accelerating Change Collaborative Series: A Challenge for Industry,” Quality Progress, Jan 1999, p55

49 HRSA’s 9-Step Model to Quality
Goal of Manual: provide the tools to develop and implement a quality management program outline a step-by-step process that can be applied in any care setting applicable for both the experienced and non-experienced grantee Developed by HIV/AIDS Bureau Quality Institute

50 HRSA’s 9-Step Model to Quality
Commit Leadership & Supportive Organizational Structure Establish support of program leadership for Quality Management Delineate specific QM responsibilities of staff Establish Quality Management Plan Establish Quality Committee to oversee the QM program Develop an organizational QM plan which delineates goals and objectives for the QM program Determine Performance Measures & Collect Data Based on QM priorities, develop/adopt indicators to measure performance Determine method of data collection and collect data

51 HRSA’s 9-Step Model to Quality
Analyze Data Analyze data and review the results Identify areas where additional data is required Develop Project-Specific CQI Plan Establish project-specific QM team to improve specific aspects of care/services Develop timeline for reporting findings and improvement Study and Understand the Process Utilize QI tools and techniques to understand the process Report progress to senior leadership and staff

52 HRSA’s 9-Step Model to Quality
Develop and Implement an Improvement Plan Identify potential solutions to make improvement to the systems of care. Try a small test of change and analyze results. Re-measurement Re-measure indicator after change has been implemented. Determine need for and/or level of re-measurement on an ongoing basis. Celebrate Success Communicate results of the project to all levels of the organization Congratulate team in public forum

53 References HAB Quality Management Manual, HRSA HIV/AIDS Bureau website; hab.hrsa.gov/tools/QM

54 Scenario – Group Exercise
Clemens Steinbock, MBA NationalQualityCenter.org 86,408 PLWA – reported in the 8 states At least 43,000 PLHIV – estimated TOTAL POTENTIAL IMPACT: IMPROVING THE QUALITY OF CARE FOR 129,000 PLHIV/AIDS -- >10% of PLHIV/AIDS in United States

55 HAB Quality Expectations
Clemens Steinbock, MBA NationalQualityCenter.org 86,408 PLWA – reported in the 8 states At least 43,000 PLHIV – estimated TOTAL POTENTIAL IMPACT: IMPROVING THE QUALITY OF CARE FOR 129,000 PLHIV/AIDS -- >10% of PLHIV/AIDS in United States

56 Update: Ryan White HIV/AIDS Treatment Modernization Act of 2006 – PL 109-415
Reauthorized for which sunsets 9/30/09 Increased focus on living HIV and AIDS cases over the last calendar year Increased focus on expenditures for core medical services Increased focus on coordination and integration of care and prevention at federal, state and local levels Significant changes include: Part A eligibility definition, funding formulas, hold harmless percentages, annual sample audits, biannual reports to congress on funds expended, consequences for failure to comply See a Side-by-side comparison at

57 Ryan White HIV/AIDS Treatment Modernization Act of 2006
“The chief elected official/ grantee… shall provide for the establishment of a clinical quality management program to assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infection, and as applicable, to develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV health services”

58 Ryan White HIV/AIDS Treatment Modernization Act of 2006
“RWCA grantees are directed to establish clinical quality management programs to …” “assess the extent to which HIV health services are consistent with the most recent Public Health Service (PHS) guidelines…” “develop strategies for ensuring that such services are consistent with the guidelines for improvement in access to and quality of HIV health services”

59 Ryan White HIV/AIDS Treatment Modernization Act of 2006
“RWCA grantees are directed to establish clinical quality management programs..” which include: Development of a comprehensive clinical quality management infrastructure, including routine QM meetings with cross-functional representation Description of QM program in a written quality plan, with a clear indication of responsibilities and responsible parties Inclusion and involvement of key stakeholders in your quality program Designated leaders for quality improvement and accountability

60 Ryan White HIV/AIDS Treatment Modernization Act of 2006
“assess the extent to which HIV health services are consistent with the most recent Public Health Service (PHS) guidelines…” which includes: Development and/or adaptation of quality indicators for key clinical and service categories Routine performance measurement of key care aspects Sharing of performance data with program staff Use of data to improve the organization’s performance on key services

61 Ryan White HIV/AIDS Treatment Modernization Act of 2006
“develop strategies for ensuring that such services are consistent with the guidelines for improvement in access to and quality of HIV service…” that include: Linking performance data results to quality improvement activities Establishment of quality improvement teams with cross-functional representation Integration of changes into routine program activities

62 Key Characteristics of a Quality Management Program
Patient-centeredness is a fundamental focus of quality care and undergirds the 5 characteristics that follow. 1. A systematic process with identified leadership, accountability, and dedicated resources available to the program 2. Use data and measurable outcomes to determine progress toward relevant, evidenced-based benchmarks 3. Focus on linkages, efficiencies and provider, and client expectation in addressing outcome improvement

63 Key Characteristics of a Quality Management Program (cont.)
4. A continuous process that is adaptive to change and that fits within the framework of other programmatic quality assurance and quality improvement activities 5. Ensure that data collected are fed back into the quality improvement process to assure that goals are accomplished and that they are concurrent with improved outcomes

64 Quality Improvement Resources: Websites, Publications, Technical Assistance
86,408 PLWA – reported in the 8 states At least 43,000 PLHIV – estimated TOTAL POTENTIAL IMPACT: IMPROVING THE QUALITY OF CARE FOR 129,000 PLHIV/AIDS -- >10% of PLHIV/AIDS in United States

65 Quality Improvement Websites
NationalQualityCenter.org HIV measures Change ideas Best practices Tools/resources Literature FAQ Each of these organizations has a web site, which we recommend you explore. First, NQC’s web site is at nationalqualitycenter.org. This web site is designed to provide cutting-edge information on measures of quality in HIV care, ideas for changes that will result in improvement, best practices in providing HIV care and services, tools and other resources to strengthen quality management programs and quality improvement work, recent literature and answers to frequently asked questions. More than 170 different tools are currently posted on the website. The NQC website contains links to the other sites mentioned in this Tutorial, so don’t worry if you don’t catch all the names.

66 Quality Improvement Websites
HIV QI publications Measures HIVQUAL Project Clinical guidelines Recent news and events The National HIVQUAL Project’s website is at Managed in concert with Johns Hopkins University, the website provides access to a wide range of publications about HIV care and quality improvement, information about measures of quality for HIV care, and more details about the HIVQUAL Project and how to become involved. The site also details clinical practice guidelines and links to articles about recent developments in the clinical care of people with HIV and AIDS.

67 Websites for Quality Improvement
hab.hrsa.gov HRSA QI expectations QI Tools TA Resources

68 QI Learning Resources Starting to Learn about Quality Improvement
Measuring Quality of HIV Care Measurement Setting up a QM Infrastructure Writing a Quality Management Plan Conducting Quality Improvement Activities

69 QI Teaching Resources Teaching Quality Improvement Fundamentals
Teaching Performance Measurement Teaching QM Infrastructure Teaching Quality Improvement Activities Teaching Patients on Quality

70 Consumer Involvement Training Materials
Soliciting Patient Feedback Empowering Patients to Partner with their Health Care Providers Maintaining a Patient Health Record Best Practices for Consumer Involvement Teaching Providers about Patient Self-Management

71 Quality Academy (Online Training Course)
Online quality improvement training course – at no cost available 24/7 (also available on CD-Rom) Interactivity through test questions and online exercises 20 QI topics from beginner (e.g., QI 101, PDSA) to advanced levels (e.g., dealing with resistance) NationalQualityCenter.org/QualityAcademy

72 Quality Improvement Publications
There are many publications available to help your organization in its quality improvement work. “Measuring Clinical Performance: A Guide for HIV Health Care Providers” is a publication we will mention often during The Quality Academy. The New York State Department of Health AIDS Institute developed this guide that includes a step-by-step process for measuring clinical performance with the goal of improving quality of care. This guide, and other quality improvement resources can be downloaded when clicking on the documents on your screen. A second, valuable New York State Department of Health AIDS Institute publication is “Patient Satisfaction Survey for HIV Ambulatory Care.” Patient satisfaction is an important element of the quality of care, but good surveys are difficult to develop. This is believed to be the first HIV-specific validated satisfaction survey with 5 modules, including case management, women’s health, substance use, etc. This tool is also available in Spanish.

73 Quality Improvement Publications
On your left you see the HIVQUAL Workbook, a comprehensive guide to quality improvement in HIV care developed in the 8 years of the HIVQUAL Project’s work. The guide covers both organizational infrastructure and specific quality activities, with many practical examples, tips, and tools for success. If you want to learn more about quality improvement in HIV care, study this detailed book and its chapters. On the right is a screenshot of the HIVQUAL data collection software, called HIVQUAL3. This software gives HIV programs and services an easy way to collect data on performance on the HIVQUAL quality-of-care indicators and to submit reports to the HIVQUAL staff to be aggregated into national program reports. It also includes adult, pediatric and case management indicators. While it is quite useful, please be reminded that it is not an electronic medical record.

74 Quality Improvement Publications
Here are two resources for those who are training others on the topic of quality improvement in HIV care. The HIVQUAL Project’s Group Learning Guide contains instructions for 23 interactive exercises that teach the key points of quality improvement, gleaned from workshops held with HIV providers in the HIVQUAL Project. The Group Learning Guide includes facilitator notes, interactive group exercises, presentation slides and answer keys. The NQC Game Guide contains 20 creative, engaging and interactive exercises that teach the key principles of quality improvement in HIV care. Use these exercises to help create enthusiasm for quality improvement work in your organization. The Guide includes facilitator notes and practical tips on how to apply “lessons learned” in HIV care.

75 Quality Improvement Publications
As we’ve mentioned in other Tutorials, it is vitally important to also involve consumers in your quality improvement work. Here are two resources for empowering consumers and involving them in quality improvement activities. On the left, you see “Making Sure Your HIV Care is the Best it Can Be,” a guide for facilitators to train consumers in how to understand HIV clinical care performance data and more importantly how consumers can become empowered to partner with health care providers. And on your right, ‘A Guide to Consumer Involvement’ details strategies and practices how to best solicit consumer feedback and involve consumers in quality improvement related activities. The Guide also includes lessons learned how to best identify and overcome barriers to consumer involvement.

76 Quality Improvement Publications
As we’ve mentioned in other Tutorials, it is vitally important to also involve consumers in your quality improvement work. Here are two resources for empowering consumers and involving them in quality improvement activities. On the left, you see “Making Sure Your HIV Care is the Best it Can Be,” a guide for facilitators to train consumers in how to understand HIV clinical care performance data and more importantly how consumers can become empowered to partner with health care providers. And on your right, ‘A Guide to Consumer Involvement’ details strategies and practices how to best solicit consumer feedback and involve consumers in quality improvement related activities. The Guide also includes lessons learned how to best identify and overcome barriers to consumer involvement.

77 Quality Improvement Publications

78 Quality Improvement Publications

79 HIVQUAL Software and QM Plan Checklist

80 HIVQUAL Indicators – Adult and Adolescent
ARV THERAPY MANAGEMENT HIV MONITORING (CD4 and VL testing) HIV SPECIALIST CARE ANTIRETROVIRAL THERAPY MEDICATION TREATMENT EDUCATION ADHERENCE TO ARV THERAPY PCP PROPHYLAXIS MAC PROPHYLAXIS GYNECOLOGY EXAMS TUBERCULOSIS SCREENING (PPD) SYPHILIS SCREENING HEPATITIS C SCREENING VACCINATION SUBSTANCE USE MENTAL HEALTH CARE DENTAL CARE OPHTHALMOLOGICAL CARE LIPID SCREENING BASIC PATIENT EDUCATION

81 HIVQUAL Indicators – Pediatric
PCP PROPHYLAXIS MAC PROPHYLAXIS ROUTINE VACCINATIONS NEURODEVELOPMENTAL ASSESSMENTS MULTIDISCIPLINARY CARE PLAN ARV THERAPY MANAGEMENT HIV MONITORING (CD4 and VL testing) HIV PEDIATRIC SPECIALIST CARE ANTIRETROVIRAL THERAPY MEDICATION ADHERENCE

82 HIVQUAL Indicators – Case Management
Complete psychosocial assessment Patient Knowledge Screening Treatment Adherence Assessment Service Care Plan & Coordination of Care Access and Continuity Self-Management: Client Participation in Care Planning

83 Technical Assistance Resources
National Quality Center (NQC) NYSDOH AIDS Institute 90 Church Street—13th Floor New York, NY 888-NQC-QI-TA

84 Technical Assistance Resources
National HIVQUAL Project NYSDOH AIDS Institute 90 Church Street—13th Floor New York, NY

85 Evaluation

86 How do you rate this workshop?
Very Good Good Okay So, So Not Very Good 10

87 The workshop kept me interested and engaged?
Strongly Agree Agree Neutral Disagree Strongly Disagree 10

88 The workshop gave me practical strategies and solutions to use at my HIV program.
Strongly Agree Agree Neutral Disagree Strongly Disagree 10

89 The workshop topic was relevant to me and my HIV program.
Strongly Agree Agree Neutral Disagree Strongly Disagree 10

90 The presenters at this workshop were experts and answered questions effectively.
Strongly Agree Agree Neutral Disagree Strongly Disagree 10

91 The workshop had the right balance of lecture and interactive activities.
Strongly Agree Agree Neutral Disagree Strongly Disagree 10

92 I liked the little remotes….
Strongly Agree Agree Neutral Disagree Strongly Disagree 10

93 Thank You :-)

94 National Quality Center (NQC)
NationalQualityCenter.org


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