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Program Evaluation and Program Improvement
Kirsten Bennett MS RD LDNovember 8, 2013Asthma Educator InstituteAlbuquerque, New Mexico
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Scope of Practice
The NAECB definition of Asthma Educator includes:
“…. The educator monitors asthma education program outcomes and recommends modifications to improve quality and effectiveness.”
(NAECB Candidate Handbook, 2002, p. 1)
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All improvement will require change
but not all change will be an improvement!
G. Langley et al The Improvement Guide. Jossey-Bass Publishers, San Francisco, 1996; xxi
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Application of Quality Improvement (QI) Methodology in Asthma Education
How can we apply QI methodology and strategies to individual care of patients with asthma?
How can we apply QI methodology and strategies to healthcare systems to improve asthma care and outcomes?
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Four Types of Program Evaluation
Programimplementation
ends here
Impact
Process
Formative
Outcome
Programimplementatio
noccurs here
Evaluation
Development
Evaluation
Implementation
3 Steps to Successful QI Define the best care that
can be provided in this setting
Identify the gap between current practice and best practice
Participate in closing that gap
F -O -C -U -S Find a time to talk Organize your team Clarify processes Understand variations Select a process to
improve
QI is a Team Sport!
Identify the gap between current practice and best practice (or current care for the individual)What is the baseline?What are the potential causes of our baseline observations?
What are potential alternatives to current practice?
S3 : The Goals of QI (Individuals or Groups)
Simple operational change
Short cycle evaluation of change
Sustainable after change is made
Applying QI to the Evaluation and Change Process
Formative P (plan)
What do we need to do and for whom and by when? Process
D (do) How will we attempt this process and who specifically will be
responsible for the various parts? Outcome
S (study) How will we measure what we are doing and what will we
compare it to? Impact
A (act) Did this attempt at change or implementation meet our
objective?
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Where do you fit?
PDSA personality exercise
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Outcomes = Benefits to or changes
Inputs
Resources dedicated
or consumed
by the program;
Constraints
Activities
What the program does with its inputs
to fulfill its mission
Outputs
The direct products of
program activities
Outcomes
Initial
All providers using EBP
with all asthma patients
Intermediate
Better asthma
control and QOL
Long-term
Fewer ED visits;
lower cost for
management
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Let’s Practice
PDSA handouts Flip Charts with Markers Scenario 1: How will we know if the current
asthma management plan documented for a patient (or population of patients) results in acceptable control (routinely and objectively?
Scenario 2: Reduce ED visits in a particular patient.
Scenario 3: Ensure every child with asthma has at least one planned visit for asthma management every 6 months.
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Thank you