Transcript Slide 1

The Quality Management Plan
The Quality Academy
Tutorial 5
Learning Objectives: You Will Learn About…
• Key terminology
• Crucial elements of a Quality Management Plan
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Quality statement
Quality improvement infrastructure
Performance measurement
Annual quality goals
Engagement of stakeholders
Evaluation
• 10 rules for success
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Learning Objectives
Quality Management Program
The term ‘Quality Management Program’
encompasses all grantee-specific quality activities,
including the formal organizational quality
infrastructure (e.g., committee structures, roles for
stakeholders, providers and consumers) and quality
improvement related activities (performance
measurement, quality improvement projects and
quality training activities).
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Key Terms
Quality Management Plan
A quality management plan is a written document that
outlines the grantee-wide HIV quality program,
including a clear indication of responsibilities and
accountability, performance measurement strategies
and goals, and elaboration of processes for ongoing
evaluation and assessment of the program.
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Key Terms
Quality Management Plan Diagram
Grant-wide Vision
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Key Terms
Strategic QM Plan
(3-5 yrs)
QM Plan (annual)
Annual Evaluation
Annual Goals
Execution
Work plan
Elements of a Quality Management Plan
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Quality statement
Quality infrastructure
Performance measurement
Annual quality goals
Engagement of stakeholders
Evaluation
QM Plan Elements
Quality Statement: What Do We Want to Be?
A brief mission statement
describing the end goal of
the HIV quality program
to which all other
activities are directed
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QM Plan Elements: Quality Statement
Tips for the Quality Statement
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Be brief
Be visionary
Include internal and external expectations
Make references to Ryan White legislative
requirements on quality management
QM Plan Elements: Quality Statement
Infrastructure: How are We Organized?
• Leadership
• Accountability
• Quality committee(s)
structure
• Resources
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QM Plan Elements: Quality Statement
Tips for the Quality Infrastructure
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3 to 5 pages
Job functions
All stakeholders
List linkages
QM Plan Elements: Quality Statement
Performance Measurement: How Will We Assess
Progress?
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Identify what’s important
Develop ways to measure;
Include process, outcome,
and satisfaction measures
QM Plan Elements: Performance Measurement
Tips for Performance Measurement
• Develop quality indicators
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relevance
measurability
accuracy
improvability
• Include a portfolio of process
• Who, When & How
• Reporting strategies
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QM Plan Elements: Performance Measurement
Annual Quality Goals: What are the Priorities for the
Quality Program?
Quality goals are endpoints or conditions toward which a
quality program will direct its efforts and resources.
Three things to look at in designing goals:
• Frequency: How many patients/clients received and how
many did not receive the standard of care/services?
• Impact: What is the effect on patient health if they do not
receive this care/service?
• Feasibility: Can something be done about this problem with
the resources available?
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QM Plan Elements: Annual Goals
Tips for Annual Quality Goals
No more than 5
measurable goals
Use a broad range
of goals
Establish performance
targets to achieve
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QM Plan Elements: Annual Goals
Engagement of Stakeholders
How will staff, providers, consumers and others be
involved in the QM program?
• Engage internal and external stakeholders
• Communicate information about quality
improvement activities
• Provide opportunities for learning about quality
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QM Plan Elements: Stakeholders
Tips for Engagement of Stakeholders
• Outline internal and external stakeholder
functions/responsibilities
• Include
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Providers
Consumers
Subgrantees
other Ryan White CARE Act Titles
• List proposed training opportunities
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QM Plan Elements: Stakeholders
Evaluation: How Will We Assess the Quality
Management Program’s Performance?
Infrastructure
• Did we improve HIV
care and services?
QI activities
• Were goals met?
• How effectively?
• Do we require further
adjustment?
Performance measures
• Did work plan go as
planned?
• Were established
milestones hit?
• Were stakeholders
informed?
• Was training provided?
• Are results in the
expected range?
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QM Plan Elements: Evaluation
Tips for Evaluation
• Detail when and who is performing the evaluation
• Compare annual quality goals with year-end results
• Use findings to plan next year’s activities; learn and
respond from past performance
• Routinely use organizational assessment tools
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QM Plan Elements: Evaluation
Elements of a Quality Management Plan
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Quality statement
Quality infrastructure
Performance measurement
Annual quality goals
Engagement of stakeholders
Evaluation
QM Plan Elements
TA Resource: Quality Management Plan Checklist
Checklist for the review of an HIVspecific Quality Management Plan:
http://www.ihi.org/IHI/Topics/HIVAIDS/
HIVDiseaseGeneral/Tools/HIVSpecificQM
PlanReviewChecklist.htm
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QM Plan Elements
Elements include:
• Quality statement
• Quality infrastructure
• QM Plan implementation
• Performance measurement
• Annual quality goals
• Engagement of stakeholders
• Evaluation
• Capacity Building
• Process to update QM Plan
• Communication
• Formatting
The 10 QM Plan Rules
1. Do not reinvent the wheel, use established
frameworks to get started
2. ‘Steal Shamelessly, Share Senselessly’
3. Size does not matter
4. 80% planning, 20% writing (old software
programming rule)
5. A few visionary annual goals are better than plenty
of useful ones
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10 QM Plan Rules
The 10 QM Plan Rules (cont.)
6. Be inclusive, even it takes longer to get your final
QM plan
7. If you have not touched your plan in the last 6
months, bring it to the next quality committee
meeting
8. A perfect plan is never written
9. Plans are only as good as their implementation
10. Get started
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10 QM Plan Rules
Resources
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HRSA’s Quality Management TA Manual outlines a nine-step plan for implementing quality
management programs. The manual provides concrete examples and outlines the
expectations and legislative requirements of CARE Act grantees. The manual can be
downloaded from: http://hab.hrsa.gov/tools/QM. The manual is now also available in
Spanish: Supervisión de la Calidad: Manual de Asistencia Técnica, at:
http://hab.hrsa.gov/tools/QMespanol/
For guidance in teaching small groups how to develop a quality improvement management
plan, see the HIVQUAL Group Learning Guide "Quality Improvement Management Plan"
exercise. You can download this publication at www.hivguidelines.org.
For possible quality of care indicators:
• New York State DOH AIDS Institute (www.hivguidelines.org)
• Improving Care for People Living with HIV/AIDS Disease. Institute for Health Care
Improvement, HRSA/HAB. HIV/AIDS Bureau Collaborative. Order via the HRSA
Information Center (www.ask.hrsa.gov/detail.cfm?id=HAB00289) or call 888-ASKHRSA.
• National Quality Measures Clearinghouse (www.qualitymeasures.ahrq.gov)
For examples and other general tips: The HIVQUAL Workbook, especially pp. 38-54. You
can download this publication at www.hivguidelines.org .
Resources
Resources
Measuring Clinical Performance: A Guide for HIV Health Care Providers. A publication of the
AIDS Education Training Centers and the New York State Department of Health, AIDS
Institute, 2002. The guide can be downloaded at :
http://www.hivguidelines.org/public_html/center/quality-ofcare/perform_guide/perform_guide.pdf.
CAREWare is a management information system that helps Ryan White CARE Act grantees
and service providers collect, manage and report client-level data. It is available on the HRSA
web site at http://hab.hrsa.gov/careware.
Agins, Bruce D., Gary R. Burke, William C. Ellis, Frances F. Rotunno, and Michael T. Young. A
Statewide Program to Evaluate the Quality of Care Provided to Persons with HIV Infection,
Journal on Quality Improvement, September 1995.
Agresti, Alan An Introduction to Categorical Data Analysis, Wiley Series in Probability and
Statistics. Applied Probability and Statistics, May 1996.
Carey, R.G., and R.C. Lloyd. Measuring Quality Improvement in Healthcare. New York: Quality
Resources, 1995.
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Resources
Related Tutorials
• To learn more about establishing a quality
infrastructure, study Tutorial 6
• To learn more about where you can find quality
resources, study Tutorial 5
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Related Tutorials
The Quality Academy
For further information, contact:
National Quality Center
New York State Dept. of Health
90 Church Street, 13fl
New York, NY 10007-2919
Work: 212.417.4730
Fax: 212.417.4684
Email: [email protected]
Or visit us online at www.NationalQualityCenter.org
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In Closing