Quality Assurance Continuous Quality Improvement within Ryan White Programs

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Quality Assurance/ Continuous Quality Improvement
within Ryan White Programs

• Elizabeth Harkey, RN
• University of Florida, HSC
• Jacksonville, FL

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Disclosure of Financial Relationships

• This speaker has no significant financial
  relationships with commercial entities to
  disclose.

This slide set has been peer-reviewed to ensure
that there are no conflicts of interest
represented in the presentation.
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Quality Assurance

• A program for the systematic monitoring and
  evaluation of the various aspects of a project,
  service, or facility to ensure that standards of
  quality are being met.

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Main Goal

• Quality assurance ensures that all processes
  work effectively and synchronously to achieve
  quality health care.

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• Its often said that people dont resist change
  so much as they resist being changed.
• Excerpted from Brien Palmer, Making Change Work
  Practical Tools for Overcoming Human Resistance
  to Change, ASQ Quality Press, 2004, pages xv-xvi,
  7-9.

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Quality is doing the right thing, right, the
first time and doing it better the next time,
with the resource constraints and the
satisfaction of the community(Ministry of
health and Population of Malawi 1997)
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Why is this Important?

• Evidence based Guidelines to reduce
• Medical errors
• Safeguarding patient safety
• Efforts to reduce waste and inefficiency
• AND while doing this to ensure the resources are
  used to derive their full impact

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Dimensions of Quality

• Technical Performance
• Access to Services
• Effectiveness of Care
• Efficiency of Service Delivery
• Interpersonal Relations
• Continuity of Services
• Safety
• Physical Infrastructure and Comfort
• Choice of Services

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Core Activities of Quality Assurance

• Three Core QA Activities
• Defining Quality
• Measuring Quality
• Improving Quality

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Core Activities of QA

• Defining Quality developing expectations or
  standards of quality
• Measuring Quality documenting current levels of
  performance or compliance with expected standards

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Core Activities of QA

• Improving Quality Application of quality
  improvement methods and tools
• Attempting to close the gap
• Between current levels and expected levels of
  quality
• Understanding and addressing system deficiencies
  and strengths

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Four Steps to Quality Improvement
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CQI Calendar
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Where to go from here

• To identify items that are important utilize
  resources
• Local Ryan White
• AETC
• HRSA

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Areas that can be looked at

• Clinical Care
• Case Management
• HERR
• Medication Adherence
• Any System that impacts the clients we serve
• Clients are not just the ones who pay

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Just to get you startedClinical

• Complete Initial History
• Risk Assessment
• Physical Exam
• Vision, Dental
• Pap Smears
• STD/ Hep B and C Screen
• Fasting Lipids
• PPD

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Just to get you StartedCase Management

• Intakes and Updates
• Consents for Provider Networks
• Eligibility/ Ineligibility Forms
• Financial Evaluation
• Home Visits
• Care Plans

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Just to get you startedHERR / Adherence

• High Risk Evaluation
• Discussion of Safer Sex Practices
• Adherence Questionnaires
• Adherence Interventions and Discussion

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• So the job of change management is clear In a
  nutshell, you have to explain why the affected
  people should want to change, and thereby
  cultivate readiness instead of resistance.
• Excerpted from Brien Palmer, Making Change Work
  Practical Tools for Overcoming Human Resistance
  to Change, ASQ Quality Press, 2004, pages xv-xvi,
  7-9.

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Resources

• Florida AIDS Education Training Center
• Center of Human Services Sustaining Quality of
  Health Care
• Ryan White Area 4 Monitoring Tools
• American Society for Quality

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• http//www.qaproject.org/methods/resqa.html
• http//pdf.dec.org/pdf_docs/PNACS123.pdfsearch'q
  uality20assurance20in20healthcare
• http//www.asq.org/