Health Quality implementation-execution
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This document outlines steps for designing and implementing a quality improvement program at a health care organization. It discusses creating infrastructure for quality improvement, selecting performance measures, collecting and analyzing data, planning and implementing changes, and monitoring performance over time. The document provides guidance on developing a quality improvement plan, identifying improvement opportunities, testing changes, and sustaining improvements. It emphasizes establishing a quality improvement culture and integrating these efforts into existing processes.
Health Quality implementation-execution
- 1. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A How To Design a Health Care Quality Improvement Program
- 2. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Learning series on quality improvement planning Focus on implementation Roadmap for getting there Create a QI infrastructure Seek resources and technical assistance Third-party quality recognition Build on partnerships with the national cooperative agreements
- 3. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A % entered prenatal care in the first trimester % of children received all recommended immunizations by 2nd birthday Hypertensive Patients with Blood Pressure<= 140/90 % Diabetic Patients with HbA1c <= 8 Total Cost per Patient Cost per Medical Visit
- 4. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Improve Access to Quality Health Care and Services Community/new site development Expansion planning Patient-centered medical/health home development Strengthen the Health Workforce recruitment and retention Build Healthy Communities and Improve Health Equity
- 5. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Develop and enhance access points Transform care delivery system Recruit, develop, retain skilled workforce Integrate Health Center into local health systems - Specialists, ER Public Health Align policies and programs where possible
- 6. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Performance Profile (National/State) -- Number & Percent of Health Centers Meet Meaningful Use Standards Achieve National Quality Recognition Exceed Healthy People Goals (Core Clinical Measures) Increase in Cost/Patient Less than National Increase in Patients Going Concern Issues Claims/Visit 60 or 30 Day Progressive Actions 1 year Project Periods
- 7. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Ongoing QI/QA Plan encompassing management and clinical services maintaining. Confidentiality of patient records. Focused responsibility for QI. Periodic assessments of appropriate service use and quality.
- 8. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Roadmap for HC organization (1)Leadership, focus, & prioritization. (2)Efficient coordination of staff & resources. (3)Better outcomes. (4)Satisfy external requirements. (5)CBAHI, State. (6)Third-party quality. (7)accreditation and recognition.
- 9. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A OK Great!! So how do we actually do this when we are: Short staffed. Busy with lots of complicated patients. Short on resources (shouldn’t all our money go for patient care?). Lacking QI skills (not covered well in medical school, nursing school, business school).
- 10. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Depends on where you are, who you are, when you began, how big you are… One site 3 providers rural-Urban 2,000 users 12 sites Khobar providers 100,000 users history of organization, fully implemented EHR for 4 years New start 2010 paper medical records
- 11. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A The Steps (1)Design the Basic Structures. (2)Evaluate & Determine Priorities. (3)Select Performance Measures. (4)Collect Data/Determine a Baseline. (5)Analyze Data/Evaluate Performance. (6)Plan & Implement Changes for Improvement. (7)Monitor Performance Over Time.
- 12. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Quality as an integral part of the organization’s “culture” Buy-in at all levels. Board, management, staff and patients. Resources—staff time, meetings, information systems. Provide education.
- 13. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A QI Committee QI Plan & Health care plan QI calendar Clinical practice guidelines Policies & procedures Peer review Chart audits Patient satisfaction surveys Tracking systems Credentialing and privileging Data sources
- 14. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Set goals for measures A SMART goal is a goal that is Specific, Measurable, Attainable, Relevant and Time based. In other wor ds,a goal that is ver y clear& easily under stood.
- 15. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Define measurement population and delineate eligibility criteria. Create a data collection plan to include: Sampling strategy. Determine method of data collection, i.e. chart abstraction, interviews.
- 16. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Create data collection tools Design instructions for data collection tools. Train personnel who will collect data. Conduct pilot test of tool. Establish process of communicating with staff about measurement process. Collect data.
- 17. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A i.Analyze data and review the results. ii.Identify areas where additional data is required. iii.If historical data are available, compare for trends. iv.Display and distribute data to communicate findings and results. v.Identify areas for improvement and select a quality improvement project.
- 18. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A
- 19. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A i.Develop a time line or calendar of activities for the year. ii.Select a QI approach, iii. such as the Chronic Care Model. iv.Clarify QI responsibilities of staff.
- 20. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Identify potential solutions to make improvement to the systems of care. Recognize quick fixes and longer term solutions. Try a small test of change and analyze results. Refine improvement plan. Develop timeline for implementation of plan. Delineate team responsibilities. Implement changes. Track changes and improvement actions
- 21. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A i.Determine interval for re-measurement. ii.Remeasure indicator after change has been implemented. iii.Look for incremental improvement. iv.Communicate results to team, staff and leadership. v.Develop a plan for sustained improvement.
- 22. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Processes (1)Chronic Diseases Care being implemented (2)Staff training. (3)Patient education. (4)Plan to institute new consent form (5) specific for women’s health and policy to ensure its use.
- 23. S ilv e r C r e s c e n t D is p e n s a r y – K h o b a r - K S A Implementing your QI plan (1) How to choose specific strategies. (2) How to evaluate. (3) Connection to risk management, peer review accreditation. (4) How to use the collected data, to fuel your QI process. (5) Setting goals and performance metrics. (6) Increasing data reliability.