If you are having trouble with Webex, please call 1-800-857-8777 Welcome to the NQC Technical Assistance Call: Engaging Provider Staff and Consumers in Quality Improvement for Part A and B Grantees September 13, 2007 If you are having trouble with Webex, please call 1-800-857-8777

Agenda for the Call Short slide presentation: Importance of engaging consumers and staff. Potential roles in QI. Barriers to participation. One Grantee’s Experiences: Simone Douglas Anthony, Detroit EMA Open discussion: what has and hasn’t worked in your programs. Comments from panel of grantees and consumers Some ideas to take away and try….

Key Stakeholders: Consumers Most likely to be in touch with their peers’ lives; for example, can help Design surveys and reports. Participate in focus groups or interviews to identify which improvements will likely make most difference for fellow consumers. Can serve as a “reality check” and help keep the providers from getting “lazy” or setting goals too low. They are the most effective counter-voice to bossy clinicians.

Consumer Involvement Can Take on Many Forms Focus Groups Needs Assessments Key Informant Interviews Client Satisfaction Surveys PLWHA representation at all levels within the agency: Board of Directors Staff (representative of the client population being served by the agency) Client or Patient Advisory Committee (CAC) Serve on agency/grantee QC

Consumers on the QC: Barriers Consumers may experience: Feeling that their input isn’t being used Lack of orientation and training Unaware of opportunities to participate Acronym angst Fear of disclosure Practical barriers: Transportation/childcare/$$/need to work/not enough time/illness or poor health Grantees may worry about: Consumers slowing down the process Consumers may pass on unflattering info Just can’t get consumers to come!

Two Flavors of Engagement Design: Integrate, or Separate? What do you think? Better for consumers to serve on the central QC, or have separate committees/input mechanisms? If separate, how do the committees communicate with each other? Should there be a formal nomination and selection process for consumers to serve on committees?

Two Flavors of Engagement Design: Integrate, or Separate? Consumer QC/CAP May be less intimidating; more input More voices, more opportunities for people to contribute Can tailor agenda and language better to consumer interests and knowledge Serve on Central QC Single committee is simpler Ability to directly influence others during discussion Challenges non-consumers to keep discussion understandable

Key Stakeholders: Provider Staff Critical role in identifying improvement ideas; they know what is practical. Often need their involvement to get access to data. System change requires a team effort if it is to be sustainable. Often more in touch than health planners are with challenges that patients/consumers are facing.

Barriers to Participation: Provider Staff The Big Four: Time Turf Trust Turnover Others: Denial Quality baggage

One Grantee’s Experience: Detroit EMA Simone Douglas Anthony, MHSA Where they started. What they tried in order to get consumer and provider participation. What has worked and what hasn’t.

Open Discussion: What Has Worked in Your Quality Program? Engaging consumers Engaging provider staff Successful strategies? Instructive or entertaining failures?

Lessons Learned: Consumer Involvement Consumers get involved and stay involved when they see their input and recommendations implemented. Consumer involvement should have written standards and a written plan (or a section in your QMP). Dedicated training on quality for consumers is critical. Highlight consumer contributions in every newsletter, report out, and conference call on quality.

Lessons Learned: Use Multiple Avenues for Consumer Involvement Consumers can: Serve on grantee/state Quality Committee(s) Create separate quality of care consumer advisory committee Train other consumers and provider staff on the what and why of quality improvement Participate on improvement project teams Give feedback/input about quality of program (surveys, focus groups..) What else?

Consumer Involvement: Lessons Learned Both documents are available via the NQC website NationalQualityCenter.org Pages 36-43 include examples of standards for consumer involvement. Extremely helpful consumer training resource.

Lessons Learned: Staff Involvement Contract language can/should be very specific about their provider QI responsibilities. Can use monitoring visits to look at/discuss actual examples/results of their QI work. Offer to do training for their staff on QI

Lessons Learned: Staff Involvement Show them the data you are getting. Take on an improvement in your own internal processes and show them you are walking the walk. Provide support staff to meetings; minutes and assisting with follow-up reminders Reduce productivity targets/case loads for those participating in QI work Pay for food for meetings (non-RWCA $) Report at every meeting and in newsletters on progress of improvement work

Contact Information Kathleen Clanon, MD NQC Consultant Oakland, CA Kclanon@jba-cht.com Simone Douglas Anthony, MHSA Quality Management - Performance Assessment Consultant Detroit Department of Health and Wellness Promotion Phone (313) 876-4913 douglass@health.ci.detroit.mi.us Bob Tracy NQC Consumer Advisory Board Bobtracy@comcast.net Dan Tietz, Consumer Advocate NYS Department of Health, AIDS Institute (518) 486-7302 det01@health.state.ny.us

National Quality Center (NQC) NYSDOH AIDS Institute 90 Church Street—13th Floor New York, NY 10007-2919 888-NQC-QI-TA Info@NationalQualityCenter.org NationalQualityCenter.org