Transcript Mental Health

Food and Nutrition Program
Performance:
2004
Franklin Laufer, Ph.D.
Office of the Medical Director
AIDS Institute
October 13, 2006
1
Why Have Indicators?
2
Why measure?
• To inform our improvement process
– Setting aims – what are we trying to accomplish?
– What changes can we make that will result in an
improvement?
– How will we know that a change is an improvement?
– “Plan-Do-Study-Act” Cycle – to guide the test of a
change to determine if a change is an improvement
•
•
•
•
Plan a change
Implement the change
Observe the results
Act on what is learned
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Indicators and Program
• Indicators should focus on
– The outcomes we desire for our clients and
– The processes to achieve these outcomes
• Indicators should focus on outcomes or processes
that
– Are relevant
– Can be improved or maintained at an appropriate level
– Can be measured
• Can be expressed quantitatively (a proportion or rate)
• Can be measured consistently within and across providers
4
“All-or-none measurement”
• Measures performance on all components or
elements of an intervention rather than focus on
each component separately (i.e., “item-by-item
measurement”)
• Focuses on the patient
– Providing all components is what’s desired
• Encourages a system perspective
• Offers a more sensitive scale for assessing
improvements
– Provide motivation to improve
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Facilities/Eligible Patients
Reviewed
• 2004: 14 facilities, 846 eligible patients
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Percent of clients
Baseline Nutritional Screening (2004)
100%
80%
75%
74%
74%
Weight
Severe
weight
loss
Level of
appetite
72%
72%
68%
60%
40%
20%
0%
Diabetes GI-related
All
or lipid
issues
elements
disorder
Element
7
Percent of clients
Prescribed HIV Medications Documented in Chart
(2004)
100%
79%
80%
60%
40%
20%
3%
0%
Documented in chart w/in 30
days of intake
Documented in chart
Documented
8
Percent of clients
Baseline Food Security Screening
within 30 days of Intake (2004)
100%
80%
60%
40%
20%
0%
72%
66%
70%
72%
Access to
food
Housing
status
Access to
cooking
facilities
Financial
status
59%
All elements
Element
9
Percent of programs
Nutritional Education (2004)
100%
79%
80%
60%
40%
21%
20%
0%
0%
Provided in at least 1
Provided in all
month on at least one months but only on
topic
one topic
Provided in all
months and on all 7
topics
Nutritional Education
10
Percent of programs
Nutritional Education Provided in at Least
One Month and Topic Addressed (2004)
100%
80%
64%
60%
57%
64%
50%
64%
71%
43%
40%
20%
0%
Dietary
habits
Food safety Diet and ARV
adherence
Diet and
special
concerns
Budgeting Nutritionaland shopping related
symptom
mgmt
Food
preparation
and cooking
Topics
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Percent of programs
Client Satisfaction Survey (2004)
100%
80%
60%
40%
36%
36%
21%
20%
21%
7%
0%
0%
0%
Overall
program
quality
Quality of
food
provided
Quality of Food meets Food meets Survey at Survey all 5
nutritional dietary needs cultural least one item
items
education
needs
Survey items
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Resource List of Community Food and Nutrition
Services (2004)
100%
Percent
80%
60%
50%
40%
20%
6%
0%
Providers distributing list to at
least one client
Clients receiving list
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Making use of the data
• Inform our improvement process
– Decide where to focus
– “Plan-Do-Study-Act” Cycle – to guide the test
of a change to determine if a change is an
improvement
•
•
•
•
Plan a change
Implement the change
Observe the results
Act on what is learned
14