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HPM Exercise 2: Application of Quality and Performance Improvement Concepts

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OutcomesOutputsIntended resultsApplication of Quality and Performance Improvement Concepts:Examples from a Tuberculosis Control ProgramApplication of Quality and Performance Improvement Concepts:Examples from a Tuberculosis Control ProgramHPM Exercise 2: Application of Quality and Performance Improvement Concepts:Examples from a Tuberculosis Control ProgramLEARNING OBJECTIVESASPH HEALTH POLICY AND MANAGEMENT DISCIPLINE-SPECIFIC COMPETENCIESASPH INTERDISCIPLINARY/CROSS-CUTTING COMPETENCIES ADDRESSED IN THIS CASE STUDYIntroduction: Quality Improvement (QI) and Logic ModelsBackground: The Control of TB in the United States and Treatment of LTBIHEALTH POLICY AND MANAGEMENT EXERCISE 2:Application of Quality and Performance ImprovementConcepts:Examples from a Tuberculosis Control Program STUDENT VERSION 1.0HPM Exercise 2: Application of Quality and Performance Improvement Concepts:Examples from a Tuberculosis Control ProgramEstimated Time to Complete This Exercise: 40 MinutesLEARNING OBJECTIVESAt the completion of these exercises, participants should be able to: Describe the purpose, basic steps, and components of quality improvement Explain how the components of quality improvement fit within the logic model structure Select program inputs, outputs, and outcomes to be assessed as part of quality improvement effortsASPH HEALTH POLICY AND MANAGEMENT DISCIPLINE-SPECIFIC COMPETENCIES D.7. Apply quality and performance improvement concepts to address organizational improvement issuesASPH INTERDISCIPLINARY/CROSS-CUTTING COMPETENCIES ADDRESSED IN THIS CASE STUDYK.4. [Program Planning] Explain the contribution of logic models in program development, implementation, and evaluationK. 5. [Program Planning] Differentiate among goals, measurable objectives, related activities, and expected outcomes for a public health programThis material was developed by the staff at the Global Tuberculosis Institute (GTBI), one of four Regional Training and Medical Consultation Centers funded by the Centers for Disease Control and Prevention, in collaboration with the Charles P Felton National Tuberculosis Center. It is published for learning purposes only. Author: Julie Franks, PhDCharles P Felton National Tuberculosis CenterFor further information, please contact:New Jersey Medical School GTBI225 Warren StreetP.O. Box 1709Newark, NJ 07101-1709or by phone at 973-972-0979Suggested citation: New Jersey Medical School Global Tuberculosis Institute. Incorporating Tuberculosis into Public Health Core Curriculum./ 2009: Health Policy and Management Exercise 2: Application of Quality and Performance Improvement Concepts: Examples from a Tuberculosis Control Program STUDENT version 1.0.1HEALTH POLICY AND MANAGEMENT EXERCISE 2:Application of Quality and Performance ImprovementConcepts:Examples from a Tuberculosis Control Program STUDENT VERSION 1.0Introduction: Quality Improvement (QI) and Logic ModelsQI refers to efforts to continuously monitor and improve program services by systematically assessing relationships among essential program components: problems to be addressed by the program, the program’s organizational context, resources, activities, service outputs, short- and long-term objectives, and goals. QI is built into routine program activities and is undertaken from within an organization, so that administrators, managers, and service providers are engaged in monitoring and improving progress toward program objectives and goals. Because QI is an integral part of program activities, planning for and implementing QI are also integrated into program planning. Many public service programs rely on logic models for program planning. Logic models are particularly useful for focusing QI activities and implementing improvements suggested by QI.A logic model presents a systematic, graphic representation of the intended links among problems to be addressed, program resources, activities, and outcomes. While the visual scheme of a logic model may vary, it will contain the core components described in the following section.Logic Model Core ComponentsInputs are the enabling and constraining factors that influence a program’s progress toward its goals. The magnitude and characteristics of problems to which the program responds are crucial contextual inputs, as are infrastructure and financial, human, and community resources. In some very basic logic models, the category of inputs may be designated simplyas resources. However, the model’s capacity to describe the program is increased if it includes the health burden or specific problem addressed in a program and contextual factorsthat impact a program’s design and implementation.Activities include service provision and the necessary steps of program implementation in allits phases. Hiring processes and the establishment of community partnerships are crucial activities in the early phases of program development, as are providing adequate training andsupervision of staff. Collecting data to monitor progress in meeting program objectives, disseminating program results, and expanding the funding base are more significant activitiesin a mature program.Outputs are the direct products of program activities, such as services delivered or products completed, which provide evidence of service delivery to the target audience as intended. Outputs may also be evidence of program development, such as number of people hired and trained.2HEALTH POLICY AND MANAGEMENT EXERCISE 2:Application of Quality and Performance ImprovementConcepts:Examples from a Tuberculosis Control Program STUDENT VERSION 1.0Outcomes are specific, measurable changes that are linked to program activities and outputs. Such changes may occur in knowledge, behaviors, or skills of a program’s target population. Outcomes are often measured as short-term or long-term. Short-term results, such as the proportion of a target audience completing prescribed treatment are achieved within a given reporting period, such as quarterly, semiannually, or annually. Long-term outcomes, such as decrease in disease incidence within a target population, manifest over reporting periods or several years of program activities. Outcomes reflect a program’s progress in meeting specific objectives and can provide the impetus for designing or refining QI efforts that will lead to program improvements. Goals are broad-ranging, fundamental changes linked to program efforts. The goal is realized only after


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