OMHSAS Quality Management Older Adult Committee May 3, 2007

What is Quality Management? An organized process to: Collect meaningful data, Turn the data into information Use that information to move the system forward to meet your goals.

Common Issues in Quality Management “You can’t tell if you are getting there if you don’t know where you are going” “Data rich, information poor”

Factors in Quality Management Relevance The impact of the factor merits the time and effort spent measuring it, and is it actionable. Replicability The intervention will achieve a predicted result all or most of the time. Attribution Results are clearly attributable to what you measured and not to other things you haven’t measured. Satisfaction The results meet or exceed the consumers expectations

Types of Data Encounter/claims data Survey Data Study Data Other

Type of Data - Encounters Claims or encounter data – Who got the service? How much service was delivered? How much did it cost? How do counties compare to each other? How does our data compare to national standards?

Encounter Data - PBC Performance Based Contracting Report Based largely on encounter data Measures include older adults, adults and children, mental health and substance abuse Compared against epidemiological estimates of prevalence

PBC – MH Users 18-64

PBC – SA Users 18-64

PBC – Service Users - 65+

PBC - Readmission Rate, 21 to 64

PBC - Readmission Rate, 65+

PBC - 7 Day Follow Up, 21 to 64

PBC - 7 Day Follow Up, 65+

Type of Data - Surveys Satisfaction Data – Outcomes Data – Did consumers feel the services were helpful? Depending on instruments, can be analyzed compared to other populations. Outcomes Data – How are consumers doing in their lives? How are consumers doing with their symptoms? Can be compared among programs.

Satisfaction Results Measure 3rd Qtr 2005 2nd Qtr 2006 Change Problem getting help he/she needed 35.9% 40.0% -4.1% Chance to make treatment decisions 86.7% 83.1% +3.6% Better quality of life 71.4% 79.1% +7.7%

Outcome Survey POMS – Reported on priority populations (SMI and SED) quarterly Standardized output specified No standardized tool or administration methodology defined.

Type of Data - Studies Study Data – Identify a particular issue of interest Can be conducted internally or by an external organization Chart review of a statistically valid sample Is very labor intensive; must be replicated to determine if there is change in the system.

Study Data – IPRO IP Follow-up

Study Data – IPRO IP Follow-up

Study Data – IPRO RTF Study RTF Facility Measures 2001-2002 2004-2005 Onsite meeting with family within 7 days of admission 42.3% 79.7% Documentation to OP provider sent within 7 days prior to date of discharge 5.5% 14.8% Medication rationale documented in chart discharge planning notes 40.6% 50.3%

Other - NOMS Reduced Morbidity Access/Capacity Employment/Education Retention Criminal Justice Perception of Care Stability in Housing Cost Effectiveness Social Connectness Use of EBPs