1. Funded by HRSA HIV/AIDS Bureau An Introduction to Performance Measurement for Quality Improvement Lori DeLorenzo, Jennifer Keller & Terry Bray Thursday, November 29, 8:00-9:30 am Virginia C RWA-0245 Introduction to Quality Session 301 Building a Sound Quality Management Infrastructure

2. 2 NQC and Quality Workshops at 2012 AGM

3. 3 NQC at 2012 AGM Networking Opportunities - Interact with your peers…  Tue, Nov 27 12pm: HIVQUAL Regional Group– Thurgood Marshall Ballroom West  Wed, Nov 28 12pm: in+care Campaign - Thurgood Marshall Ballroom South NQC Exhibit Booth - Stop by our booth… NQC Office Hours - Meet one of our NQC coaches...

4. National Quality Center (NQC)4 Agenda Welcome and Introductions QM Committee QM Plan Interactive Exercises

5. National Quality Center (NQC)5 Who’s in the Audience? Part Role Experience with Quality Management Committees and Quality Management Plans

6. National Quality Center (NQC)6 Most Pressing Question? What are you struggling with the most as it relates to Quality Management Committees and QM Plans?

7. National Quality Center (NQC)7 Learning Objectives Assess your quality management program using organizational assessment tools and learn how to use findings to strategically improve your program Understand how to set up and sustain an effective quality management committee Develop/update your quality management plan with key elements in collaboration with key stakeholders

8. National Quality Center (NQC)8 HAB Expectations for Quality Management A Quality Management Program should consist of a systematic process with identified leadership, accountability and dedicated resources and uses data and measureable outcomes to determine progress toward relevant, evidence-based benchmarks.  Infrastructure  Performance Measurement  Quality Improvement

9. National Quality Center (NQC)9

10. 10 Components of Quality Infrastructure Leadership Quality Committee Quality Planning

11. National Quality Center (NQC)11 Role and Purpose of Quality Committee?

12. National Quality Center (NQC)12 Responsibilities of the Quality Management Committee Strategic planning Facilitating innovation and change Providing guidance and reassurance Allocating resources Establishing a common culture

13. National Quality Center (NQC)13 Points to Ponder Who leads the Committee? Who should be on the Committee? What is the role of senior leadership as it relates to the Committee? How often should the Committee be meeting?

14. National Quality Center (NQC)14 Points to Ponder What areas should the Committee be routinely be reviewing? To whom and about what should the Committee be regularly communicating? Should the Committee be linked to other organizational committees?

15. National Quality Center (NQC)15 HIV Quality Improvement Organizational Chart

16. National Quality Center (NQC)16

17. Kansas City TGA QM Advisory Committee Structure

18. National Quality Center (NQC)18 Exercise: Assessing Your Quality Committee Fill out the Quality Committee portion (A2) of the organizational assessment (3-4 min) Share with someone you don’t know what is working well and what needs improvement (10 min) Use the action planning form to take notes

19. National Quality Center (NQC)19 Tips for Success Select a chair who will be the quality program’s champion Build a cross-functional group: draw from different service areas in the program Include individuals who have influence and can get things done Start small: recruit those most critical to the program’s success Include consumers

20. National Quality Center (NQC)20 Tips for Success Include consumers Train committee members on quality improvement Document the activities and progress Celebrate the successes Others?

21. National Quality Center (NQC)21 Purpose of QM Plan?

22. National Quality Center (NQC)22 Purpose of a Quality Management Plan Describes how the quality management program is structured, implemented & evaluated Establishes accountability and delineates responsibilities Identifies performance measurement strategies & goals  Prioritize improvement goals and projects

23. National Quality Center (NQC)23 Primary Elements of a Quality Management Plan Quality statement Quality infrastructure Performance measurement Quality improvement methodology Participation of stakeholders, including consumers Communication strategy Annual quality goals Evaluation

24. National Quality Center (NQC)24 Quality Statement Describes the purpose of the HIV quality program “ To provide the best possible care to HIV+ individuals in Central Brooklyn.” The end toward which ALL program activities are directed

25. National Quality Center (NQC)25 Quality Infrastructure Leadership – ultimate responsibility Membership – cross functional representation Roles & responsibilities Meeting structure  Facilitator/leader  Reporting mechanisms  Frequency Resources

26. National Quality Center (NQC)26 Performance Measurement Identifies and quantifies the critical aspects of care and services Integration with other Parts or accrediting bodies Identifies measures to determine the progress of the QM Program

27. National Quality Center (NQC)27 Performance Measurement Who is accountable for collecting, analyzing, and reviewing performance data and results How to report and disseminate results and findings Communicate information about quality improvement activities Use data to develop new QI activities to address identified gaps

28. National Quality Center (NQC)28 Quality Improvement Methodology Approach to QI teams Link to annual plan

29. National Quality Center (NQC)29 Participation of Stakeholders Internal & external stakeholders in the QM program Provides opportunities for learning about quality for staff Includes community representatives, as appropriate How feedback is gathered from key stakeholders

30. National Quality Center (NQC)30 Communication Strategy Outlines process to share information with all stakeholders Identifies format for communication Identifies communication intervals

31. National Quality Center (NQC)31 Annual Quality Goals Quality goals are endpoints or conditions  Few measurable and realistic goals annually (not more than 5); uses a broad range of goals  Goals are established priorities for the QM Program  Establishes thresholds at the beginning of the year for each goal

32. National Quality Center (NQC)32 QM Plan Implementation Specifies timelines for implementation to accomplish those goals – workplan Specifies accountability for implementation steps Provides milestones and associated measurable implementation objectives

33. National Quality Center (NQC)33

34. National Quality Center (NQC)34

35. National Quality Center (NQC)35 Evaluation Evaluates the effectiveness of the QM/QI infrastructure Evaluates QI activities to see if annual quality goals are met Reviews performance measures to document whether the measures are appropriate

36. National Quality Center (NQC)36 Exercise: Assessing Your QM Plan Fill out the Quality Management Plan portion (A3) of the organizational assessment (3-4 min) Share with someone you don’t know what is working well and what needs improvement (10 min) Use the action planning form to take notes

37. National Quality Center (NQC)37 Tips for Success Build in a routine process to update the QM plan Use someone outside of the process to review and provide comments Modify plan to meet YOUR agency’s needs Don’t create it as a “bookshelf” plan—use it! Others?

38. 38 NQC Website Quality Academy NQC Offerings HIVQUAL Regional Groups On-Site TA in+care Campaign NQC Trainings

39. 39 NQC Resources

40. National Quality Center (NQC)40 Additional Resources www.nationalqualitycenter.org Quality Academy tutorials are great to “prescribe” before meetings for all participants to increase their knowledge.www.nationalqualitycenter.org Measuring Clinical Performance: A Guide for HIV Health Care Providers. A publication of the AIDS Education Training Centers and the New York State Department of Health, AIDS Institute, 2006. The guide can be downloaded at: http://nationalqualitycenter.org/index.cfm/6127/13908 http://nationalqualitycenter.org/index.cfm/6127/13908 Resources

41. Lori DeLorenzo, RN, MSN National Quality Center (NQC) Consultant loridelorenzo@comcast.net Jennifer Keller, MPH Clinical Quality Administrator at Wake Forest University Medical Center jekeller@wfubmc.edu Terry Bray Quality Manager for Kansas City Part A Program terry_bray@kcmo.org

42. National Quality Center 212-417-4730 NationalQualityCenter.org Info@NationalQualityCenter.org Info@NationalQualityCenter.org