Program Evaluation and Program Improvement

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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