Directions: Below is the RWP template for each Part A subcontracted agency to utilize to develop an agency-specific Quality
Management (QM) Plan. The sections in bold identify categories of the QM plan that each agency-specific plan should include. Please fill-in the blanks with the requested information (and the information in brackets provides guidance on the information that should be included in each blank). By developing a plan in accordance with the template, the agency will be in compliance with the RWP contract requirement of having an agency-specific QM plan.
________________________
[AGENCY NAME]
Quality Management Plan
______________
[Date Implemented]
________________
[EFFECTIVE DATES]
I.
Quality Statement
The purpose of this plan is to set forth a coordinated approach to addressing quality assessment and process improvement at ____________________________ [agency name].
The program has established as its mission _______________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
[Insert mission statement, i.e. provide a brief purpose describing the end goal of the HIV quality program. The mission statement should answer the question, “ What does your
agency want for your HIV/AIDS patients?”]
II.
Quality Infrastructure
A.
QM Team and Responsibilities
The agency’s QM team is accountable, responsible and answerable for planning, directing, coordinating and improving healthcare and support services in the HIV
Program. The QM Team includes ____________________________________________
_______________________________________________________________________
_______________________________________________________________________.
[List staff and title of individuals on the QM Team, including their responsibilities]
B.
Quality Committee/Meetings
The QM Team approves the performance improvement plan, and reviews quality improvement activities during its regular meetings. Meetings are held ______________
_______________________________________________________________________.
[Identify the frequency of meetings]
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C.
QM Program Content
The program is designed to address quality regarding the following major services:
1.
________________
2.
________________
3.
________________
[List the services funded through your Part A grant. Add additional services lines if needed.]
III.
Annual Quality Goals
The following goals address an agency-wide process for planning, designing, measuring, assessing and improving performance
A.
TGA Goal 1: [insert]
B.
TGA Goal 2: [insert]
C.
TGA Goal 3: [insert]
D.
TGA Goal 4: [insert]
E.
TGA Goal 5: [insert]
F.
Agency Goal: [Insert]
[Includes the TGA-wide annual quality goals and at least 1 agency-specific goal. These goals are endpoints toward which the agency’s QM program will direct its efforts and resources.]
IV.
Performance Measurement
The selection of performance measures is based on the major functional areas and the important aspects of care and service provided by the agency. The performance measures include:
A.
TGA Indicator (if applicable)
B.
TGA Indicator (if applicable)
C.
TGA Indicator (if applicable)
D.
TGA Indicator (If applicable)
E.
TGA Indicator (if applicable)
F.
Agency Indicator
G.
Agency Indicator
H.
Agency Indicator
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[Includes the TGA-wide indicators that are relevant for the agency and at least 3 agencyspecific indictors that will aid the agency in meeting the annual quality goals indentified in section III.]
Regular review of data for performance measures will occur ___________________
[frequency of data extraction] by extracting data from CAREWare. The agency’s QM Team will review these data reports at the regularly scheduled QM meetings. ________________
[designated staff person] will ensure that data is inputted into CAREWare for the TGA QM
Lead to review the TGA Indicators at the time specified by the TGA QM Lead.
V.
Evaluation and Assessment
A.
QI Activities:
The agency will conduct at least 2 Quality Improvement (QI) activities per grant year.
These will be identified based on low performance on measures indentified in Section
IV.
B.
Agency-Specific Performance Measures:
On a semi-annual basis, the agency will review if selected performance measures are appropriate for the agency to track.
C.
QM Infrastructure:
On an annual basis, the agency will review the structure of the QM and identify areas where more resources should be allocated.
D.
Annual Update:
The agency-specific QM plan will be updated annually during the month of ________.
[insert month]
E.
Communication:
Activities conducted by the QM Team will be reported to the appropriate inter- and intra-stakeholders at the relevant times.
Signatures
__________________________________________ _________________
[Name, Title] Date
____________________________________________ _________________
[Name], Ryan White Contract Coordinator Date
___________________________________________ _________________
[Name], Ryan White Program QM Lead Date
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