| Session Title: Using the Getting To Outcomes Framework to Implement Continuous Quality Improvement in Community-Based Prevention |
| Multipaper Session 908 to be held in Mineral Hall Section G on Saturday, Nov 8, 3:05 PM to 3:50 PM |
| Sponsored by the Collaborative, Participatory & Empowerment Evaluation TIG |
| Chair(s): |
| Matthew Chinman, RAND Corporation, chinman@rand.org |
| Abstract: This session explores the use of continuous quality improvement (CQI) in community-based substance abuse prevention settings as an evaluation tool. While efforts to improve quality are widespread, often little attention is paid to engaging staff to embrace these efforts. To address this, the first paper will review multiple approaches to improve quality that focus on staff motivation and how such approaches can be used in CQI. In addition, guidance for conducting CQI in community-based substance abuse prevention is lacking. Getting To Outcomes (GTO) is a 10-step process that helps substance abuse prevention practitioners to better plan, implement, and evaluate their programming consistent with empowerment evaluation; Step 9 provides guidance for conducting CQI. Paper two describes a GTO-CQI intervention and the research conducted to document its implementation. Lessons learned about using CQI methods in community-based prevention settings will be highlighted. |
| Ideas from Near and Far with Implications for Continuous Quality Improvement |
| Gordon Hannah, Finger Lakes Law and Social Policy Center Inc, gordonjhannah@gmail.com |
| While the call for continuous quality improvement (CQI) has been widespread, the literature on how to implement effective CQI processes is relatively new and undeveloped. Literature on improving performance, however, exists in many domains and has many implications for designing CQI processes. A crucial component of improving performance and increasing the quality of programs that is often overlooked in CQI processes is staff motivation. While evidence-based techniques for enhancing motivation exist, they are seldom considered in CQI processes. This presentation will first review various approaches to enhance staff motivation for quality improvement from a broad literature, including existing CQI models (such as the Plan-Do-Study-Act cycle), models of organizational change and accountability (such as the Concerns-Based Adoption Model), the performance improvement literature, and motivational enhancement literature. Then the presentation will discuss how these different approaches to staff motivation can be used in concrete CQI efforts as prescribed by the GTO-CQI intervention. |
| The Getting To Outcomes-Continuous Quality Improvement Demonstration and Evaluation |
| Matthew Chinman, RAND Corporation, chinman@rand.org |
| Sarah B Hunter, RAND Corporation, shunter@rand.org |
| Patricia Ebener, RAND Corporation, pateb@rand.org |
| Incorporating the Institute for Healthcare Improvement (IHI) framework, experience from CQI in substance abuse treatment and input from a Work Group of prevention practitioners, a Getting To Outcomes-CQI intervention (GTO-CQI) was developed and tested by 10 prevention programs. The intervention involved semi-annual trainings and quarterly technical assistance sessions. Participating programs developed action plans and were instructed on plan-do-study-act cycles, IHI's method for making small, rapid improvements and then assessing their impact. Ten participating program directors were interviewed at 3, 6, and 9 months following the initial training about their progress on their plans. During these interviews, research staff also provided technical assistance on CQI. Results highlight the variability across the 10 programs in terms of types and scope of improvements attempted, staff enthusiasm, and implementation level. The resulting lessons learned about improving CQI implementation in these settings will be presented. |