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ATTRIBUTION BOOT CAMP

ATTRIBUTION BOOT CAMP. BASIC TRAINING TO STRENGTHEN YOUR QUALITY PLAN. OBJECTIVES. DISCUSS METHODOLIGIES USED TO ATTRIBUTE PERFORMANCE IMPROVEMENT TO OUTCOMES. DISCUSS ATTRIBUTION METHODOLIGY INTERGRATION DISCUSS RESEARCH AND QUALITY IMPROVEMENT PROJECT DESIGN . ATTRIBUTION OVERVIEW .

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ATTRIBUTION BOOT CAMP

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  1. ATTRIBUTIONBOOT CAMP BASIC TRAINING TO STRENGTHEN YOUR QUALITY PLAN Sara Meadors RN MBA, Quality Consultant Magnolia Strategies Sara@magnoliastrategies.net

  2. OBJECTIVES • DISCUSS METHODOLIGIES USED TO ATTRIBUTE PERFORMANCE IMPROVEMENT TO OUTCOMES. • DISCUSS ATTRIBUTION METHODOLIGY INTERGRATION • DISCUSS RESEARCH AND QUALITY IMPROVEMENT PROJECT DESIGN Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  3. ATTRIBUTIONOVERVIEW DEFINITION THE FORUM POSITION PROGRAM THEORY ATTRIBUTION MEASURES Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  4. KNOW YOUR GOAL! KNOW YOUR ROLE! Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  5. ATTRIBUTION Webster's definition: The act of attributing which is to explain by indicating a cause Quality improvement definition: Correlating or associating and outcome with an intervention Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  6. THE FORUM POSITION • All quality improvement projects should include attribution specific measures in addition to clinical performance measures. • Associative, observational methods are feasible for attributing improved outcomes to quality interventions • Demonstrate a RELATIONSHIP Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  7. Program Theory & Attribution “The construction of a plausible and sensible model of how a program is supposed to work.” Theory of Action: chain of events-reach program goals a. Inputs b. Activities c. Participants engage in activities d. Participants react to what they experience e. Change in knowledge, skill, attitudes, and aspirations f. Behavior and practice changes follow Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  8. Attribution Measures Link Attribution Measures to Quality Plan Goals ESRD Forum suggested measures: • Change Readiness –facilitate providers willingness to change • Structural Measures –policies/procedures • Provider Perceptions-analysis of satisfaction • Generalized, linear, hierarchical model-complex computer model Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  9. Intergration & Examples THE BASICS MAKE IT WORK PUTTING IT ALL TOGETHER REALITIES Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  10. START WITH THE BASICS • Set Mandate/ Set Culture-Motivate! • Gather Data-used to document experience • Select Problems • Plan, Do, Study, Act • Celebrate Success • Spread Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  11. MAKE IT WORK • TEAM WORK IS A MUST • DATA, DATA, DATA-TRENDS • DIALOGUE • SMALL GROUPS • VARIABLES • UTILIZE BEST PRACTICE INTERVENTIONS Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  12. A great example…….. Project Description: Education program for Programs for nephrology and surgical professionals Background: Low prevalent AVF rates Measures: Provider Perception: Attribution Scan Results: Increased average prevalent AVF rate AVF Rate for Prevalent Patients-Collaborative Education Programs Bobby Knotek, RN, BSN, CNN, CPHQ and TEAM Network 14 Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  13. QI VS RESEARCH COMPARISON CHART WHEN IN DOUBT… THREE QUESTIONS Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  14. COMPARISION RESEARCH • Investigator initiated activities. • An Activity to develop a standard of care • Interventions made available to some patients and not others • Designed to contribute to generalized knowledge • Systematic • Requires Institutional Review Board Review • Proposes comparisons of one or more prospective interventions • May be associated with risk • Hypothesis testing • QUALITY • Conducted by or for a QI organization • Related activities designed to achieve measurable improvement processes and outcomes of care • Interventions target healthcare providers, practitioners, plans, beneficiaries. • Local institution • Project is adapted over time • Does not expose patients to more than minimal risk • Protocols are not rigid or fixed Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  15. WHEN IN DOUBT…. Quality Improvement may become research when: The intention is to gain information or make improvements outside of the program to add to the “universe of general knowledge.” CONSULT YOUR POLICY and PRESENT TO THE IRB Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  16. THREE QUESTIONS • 1.Does the description of the proposed activity contemplate that individually-identifiable data elements will be collected or analyzed for any purpose other than providing direct feedback to participating institutions? Yes-Research No-QI • 2. Does the analytical or evaluative component of the activity change the way that the quality program will be implemented in such a way that risks may be higher for providers or patients who participate? Yes-Research No-QI • 3. Is there funding from an external organization based on a “research paradigm” to carry out the evaluation of the program? Yes-Research No-QI Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  17. Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

  18. QUESTIONS? Sara Meadors RN MBA, Quality Consultant Magnolia Strategies

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