USING URS for QUALITY
MANAGEMENT
• Case Study 1:
• “How many of the women currently enrolled in the
RWCA case management program are actually
receiving routine gynecological care?”
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Eligible Patients:
HIV+ women enrolled in the T-I Case Management program for the 2005 calendar
year.
Review Period:
2005 calendar year.
Indicator:
Women should receive/report an annual gyn exam.
Relation to URS
• Identifying the population of interest: in this
case, women enrolled in the RWCA case
management program for 2005
• Identifying data sources for the indicator, in this
case, referral followup.
Data Source in URS-Identify Clients
Using Client Listing by Program
Report Output
Or use Clients Served by Program
with date range.
Use Agency Referral Report to View Referrals
made by your Program for that date range
Detail on Referrals can be Viewed
Status of each Referral is included
• The status will only be available in this manner if
staff have been using the URS referral tracking
feature to its full capabilities
• Data can be exported to an Access database or
spreadsheet or Crystal Report for further
analysis and reporting.
• This is done using the URS data export feature
Referral Tracking Features
Referral Data
• Referral Service Category, specific service
• Organization (from referral library)
• Dates for need identification, referral, referral
status.
• Type of followup method is now available
• Notation of whether appointments are being
kept.
CASE STUDY #2
• evaluate the effect of group visits designed to
assist clients with building their HIV/AIDS self
management skills.
• collect the following data at baseline and
following the group interventions:
A. % of clients reporting (with documentation by the case manager in
the record) T-cell and Viral Load test result at least every 6 months.
B. T-Cell and Viral Load Results
In URS, Use Lab Test History
Data can be exported using URS
Extract
Evaluate trends in CD4 and Viral
Load
• Cross Reference the URS Client Data (client
characteristics) with URS Service data (what
services they received) with Lab Test data (Viral
Load and CD4).
• All of this data can be exported from URS if it
has been collected and entered conscientiously.
CASE STUDY #3
• review performance measures/indicators for
2006.
• First, determine eligible population:
• Patients admitted in 2006 that have been
enrolled in the Case Management program for a
minimum of 3 months
• Use client enrollment reports as in Case Study
#1.
Identify Indicators for Review Period
• The review period is defined as the (2006) calendar
year.
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Indicator 1: Clients should have a documented primary care visit at least
once every 6 months.
Indicator 1a: For clients who have not had a PCP visit within the
aforementioned time frame a referral to a PCP should be noted.
Indicator 1b: For clients with a referral to primary care provider, there
should be documentation of follow up within 30 days to determine
whether the primary care appointment was kept.
Indicator 1c: If documentation exists, there should be documentation
that the client kept the appointment.
In CURRENT URS, use Referrals
and CM Intake Data
• Referral tracking offers ability to note where the
client is receiving care, whether they have
obtained services, and whether or not
appointments are being kept.
• CM Intake gives notation of pre-existing PCP
relationship, and whether that is ongoing and
date of most recent visit.
Case Management Intake Screen
IN AIRS (VFPURS), new PCP
Screen will be available
CASE STUDY #4
• A QI project that focuses on improving the quality and
completeness of URS data entry
• test whether the following interventions will result in an
improvement in the process:
• 1) Training staff on the required data elements in URS and in
particular focusing on how to document lab test results and
HAART medications.
• 2)
Identifying a URS report that the program director can run
on a routine basis (monthly) to capture the completeness and
accuracy of client level data entered.
Documenting Lab and HAART
• Lab results can be entered in the Lab/Psych Test
History as needed. Any tests not available can
be added via the lab test maintenance function.
• HAART is monitored in the Medications History.
Both ARV type and status and specific meds
may be entered, but only ARV type and status
are required.
Lab Tests available
Medications History
Reports Available in System
• Clients Without ARV Therapy is a CADR Quality
Report
Detail on Individual Clients is Available in the
Client Profile or Flow Sheet Reports
Data Quality Checks
• Run Program enrollment by Worker, look for last
date of service
• Run Activities and Services Report by Worker,
look at level of activity and clients served
• Select client profiles for a sample group to
review completeness of records for clients seen
during the report period.
• Process is much faster than chart abstraction
CASE STUDY #5
• Determine if the following conditions posed a
barrier to one’s access to, or maintenance in,
primary care:
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Clients who were living at home (with parents);
Clients living in single room occupancy
Homeless clients
Clients in need of food/nutritional services
Clients w/ documented Substance Use problems
Data Sources in URS to Identify
Clients meeting the profile
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Housing Status on Intake
Adequate Housing Flag on Intake
Service Needs Identified during CM visits
Referrals Made
Substance Use History
Special Populations
Use data on PCP as noted in Case Study #3
AIDS Institute Aggregate Reports offer summary data
on many Intake elements
Majority of Data in First URS Extract
Table
Use of Data
• Use “canned” reports wherever possible
• Export to Spreadsheet and sort
• Export to Access Database and Run report
wizard
• Export to Crystal Reports
• Use product of your choice