1. Developing a Quality Management Plan December 2005
Presented by:
Roger Chaufournier
NQC Consultant
Chairman and CEO
Patient Infosystems

2. Attribution
The following slides prepared for this presentation were adapted from previous presentations in the Title I Collaborative and contributions were made by Lori DiLorenzo, Barbara Boushon, Ginna Crowe and the Institute for Healthcare Improvement
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3. Overview Theory Legislation Elements of a plan
What to look for in a plan

4. Theories Underpinning Quality
Deming’s theory of Profound Knowledge
System thinking
Variation in daily work
Psychology of how people adapt to change
Theory of Profound Knowledge
Juran’s Trilogy
Quality Planning
Quality Control
Quality Improvement

5. Juran Trilogy Quality Control Quality Planning Quality Improvement
Specification
Chronic Waste

6. Summary: What is it all about?
Leaders recognizing how quality aligns with the underlying business case
Empowered employees owning work processes and committed to their improvement
Accelerated translation of best practices and change concepts to daily work
Monitoring, feedback and celebration
Change agents rather than victims

7. QM Legislative Requirements
All CARE Act grantees are required to establish quality management programs to:
Assess the extent to which HIV health services are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infections; and
Develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV services

8. QM Legislative Requirements (cont.)
The overall purpose of a quality management program is to ensure that:
Services adhere to PHS guidelines and established clinical practice;
Program improvement includes supportive services linked to access and adherence to medical care; and
Demographic, clinical and utilization data are used to evaluate and address characteristics of the local epidemic.

9. Key Characteristics of QM Programs
A systematic process with identified leadership, accountability and dedicated resources;
Use of data and measurable outcomes to determine progress toward relevant, evidence-based benchmarks;
Focus on linkages, efficiencies, and provider and client expectations in addressing outcome improvement;

10. Key Characteristics of QM Programs (cont.)
Continuous process that is adaptive to change and that fits within the framework of other programmatic quality assurance and quality improvement (QI) activities;
Data collected is used to feedback into the process to assure that goals are accomplished and they are concurrent with improved outcomes.

11. Evaluating the QM Plan: Key Elements
Quality statement
Quality improvement infrastructure
Annual quality goals
Staff involvement
Evaluation
As a whole, the QM plan documents how the HIV quality program is structured and what its members hope to accomplish in the coming year. It becomes the foundation for improvement efforts at the project level.

12. Quality Statement
The end toward which all other program activities are directed
Example:
To provide state-of-the-art HIV quality of care to HIV+ adolescents in the Albany, NY area.
To ensure medical care is provided in accordance to the PHS guidelines throughout the Houston EMA.
The quality statement describes the purpose of the HIV quality program.

13. Quality Improvement Infrastructure
Leadership
Who is ultimately responsible for the HIV program’s quality initiatives?
Membership
Who will participate in the program’s quality committee?
Meeting structure
When will the committee meet to plan and assess progress?
Internal technical assistance support
Indicates how the program is staffed and structured in order to get the work done.

14. Annual Quality Goals Annual quality goals Performance measurement
Endpoints towards which the organization will direct its efforts and resources
To reduce patient ‘no-shows’ by 15%
Performance measurement
Quality of care indicators
Kept appointments
1. The true work of an HIV quality program is completed during individual quality improvement projects.
2. QM plan should include information about the yearly projects.

15. Staff Involvement Quality improvement deployment
Individuals or groups designated to implement QI projects
Communication
How does the organization share information about the quality activities and project results?
Education
How does the organization provide staff training and learning opportunities?

16. Evaluation Quality projects Quality improvement management plan
Were the projects worthwhile investments?
Can the improvements be sustained over time?
Quality improvement management plan
Does the QM plan provide the vision and organization needed to complete the quality initiatives?

17. Sustainability
Three primary strategies for strengthening program sustainability:
Communicating program success
Remeasuring performance
Building quality into daily work

18. Communicating Program Success
Develop system for employee reward and recognition
Champion staff through promotion of success stories
Exchange “best practices”-creating a learning organization

19. Remeasuring Performance
Remeasure performance at pre-established intervals
Review measurement data regularly
Respond to sub par performance in a systematic manner

20. Building Quality into Daily Work
Make QI part of job descriptions
Incorporate quality concepts into new employee training
Provide ongoing quality training
Provide opportunities to participate in QI projects
Incorporate best practices
1.Refer participants to the worksheet on sustainability
2. Can use this as you talk with the grantees about sustaining their program to help guide them.
3. These tools can be given to the grantees so that they can perform their own assessment

21. Summary Well designed program Clear Goals and Vision
Infrastructure to Support Improvement
System of Measurement
Routine Assessment
Deployment Methods for Improvement
Communication System
Alignment