Transcript Uniting

Uniting
the Two Dimensions of Quality in
New York State
By: Daniel Tietz
AIDS Program Manager for Consumer Affairs
Dan Belanger
New York State HIV Quality Program Director/AIDS Institute
Two Dimensions of Quality
Technical Quality
Experiential Quality
Provider Perception of
Quality of HIV Care
Consumer Perception of
Quality of HIV Care
Leonard Berry, Texas A&M University, IHI conference (2001)
The Organizational Assessment Process
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New York State provides an annual onsite organizational assessment of all
HIV-specific QM Programs statewide for clinics providing HIV Primary
Care
The organizational assessment reviews QM Programs for several key
components
OA Components:
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Quality Infrastructure-including leadership, quality committee, specific roles
and responsibilities
Annual Quality Plan
Annual Work plan
Performance Measurement
Annual Goals
QI Activities
QI Teams
Staff Involvement
Consumer Involvement
Evaluation of Quality program
Information system in support of Quality
All OA activity is entered into a database and reported to the NYS HIV
Quality of Care Director and members of the team.
Technical Assistance (TA)
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Technical assistance is offered to programs based on
the outcomes of the organizational assessments
through quality consultants performing the OA.
TA requests may also be made by the HIV Provider
or funding agency
Consumer Involvement in HIV QM Programs is an
area that some HIV Care Providers struggle with in
NYS
When requests for technical assistance coming out of
the OA Process are made, the NYS QOC Director
refers them to the NYS Manager for Consumer
Affairs
Barriers Encountered to
Consumer Involvement in QI in NYS
Consumers:
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Fear of disclosure
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Lack of orientation and ongoing training on QM terminology and QI initiatives
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Time to participate in meetings due to other competing priorities (work, family,
health, etc.)
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Unclear about the value: don’t believe that input matters to RW grantees/subgrantees and policy-makers
Ryan White Grantees or Sub-Grantees:
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Don’t understand the value of having consumers involved
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Lack of participation – “We can’t get folks to participate”
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Confidentiality/Boundary Issues
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Resources (staff training, time commitment, money, and other competing
priorities
Successful Solutions from NYS
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Development of a written QM plan that includes standards for
consumer involvement in QI by RW grantees
Identifying dedicated staff and other resources to work with
consumers
Recruitment, solicitation and nomination process to serve on
formal NYS RW Part B committees “NYS Quality of Care
Consumer Advisory Committee – QOC CAC.”
Developing terms of reference for NYS QOC CAC.
Assigning QOC CAC co-chairs to develop quarterly meeting
agendas
Scheduling meetings at convenient times so consumers can
participate.
Successful Solutions from NYS
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Orientation and ongoing training, coaching, and peer
mentoring on QM/QI concepts and Patient Self-Management
for RW grantees, sub-grantees, and consumers.
Participation in the development, distribution and review of
satisfaction surveys key informant interviews, and focus
groups.
Consumer participation on formal CABs, QI
teams/subcommittees, quality learning networks.
Reviewing and commenting on HIV clinical guidelines from a
consumer perspective.
Presenting QI data to consumers for the purpose of reviewing,
prioritizing, modifying and/or developing clinical indicators.
Appointing consumers to serve on Boards of Directors.
Successful Solutions from NYS
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Employing consumers with expertise on quality improvement
concepts and patient self-management.
CAC members delivering peer trainings on patient QM
concepts and patient self-management.
Participation on internal QI teams.
Emphasizing that “partnerships” is key to improving QOC
and quality of life for patients.
Publicize positive outcomes that resulted from of consumer
input
Successful Solutions from NYS
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Establishing statewide Young Adults Consumer Advisory
Committee “YACAC” to engage in QM infrastructure and
QI projects.
Basic training on patient self-management, presentation
skills, HIV confidentiality and disclosure, and
communicating/meeting with policy.
Providing input to RW grantees on HIV clinical guidelines,
QM infrastructure, QI projects, health care service delivery,
and policy issues facing young adults.
Development of Facebook page to communicate with and
educate peers.
Serving as peer educators during World AIDS Day activities
to raise HIV/AIDS awareness and by discussing realities of
living with the virus (perinatally and behaviorally infected).
Attending conferences and training peers on patient selfmanagement.
Next Steps for Sustainability in NYS
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Developing training module on “Consumer
Involvement in QI 101” with input from RW
grantees, sub-grantees, and consumers.
Training, coaching, and mentoring consultants to
promote consumer Involvement in QI among RW
grantees and sub-grantees whom consultants are
working with.
Providing individual TA to RW grantees/subgrantees on consumer involvement in QI.
Encouraging consumers to participate in Patient
Self-Management, QI 101 trainings/TOT.
Facilitating interaction between RW grantees/subgrantees and consumers through quality learning
networks and QI projects.
QI
Consumer Involvement Resources