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Organizational Issues
- Community needs assessment
- Program development based on community needs and evidence
- Program implementation
- Program evaluation
- Professional partnerships
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Needs Assessment
- A systematic exploration of the way things are and the way they should be
- A means of understanding why the program is needed and what the stakeholders expect
- Improves efficiency by understanding the problems and deficiencies in the community in question and establishing priorities for the program
- ASME standard 5
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Needs Assessment of a Program's Potential Patient Population
- Design a survey instrument
- Reaching the population
- Determine the survey mechanism
- Collect and analyze data
- Establish, implement changes or additions to present program
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Needs Assessment of a Program's Potential Physician Service Area
- Personally contact physicians in the area the program is intended to serve
- Services your program hopes to provide
- Program content, intended outcomes
- Get buy-in
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Identifying outcome indicators- Program Goals
- Financially sustainable
- Serves a community need
- Valued and supported by the organization
- Consistent with asthma guidelines
- Determine payer participation
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Identifying outcome indicators- Patient goals
- Asthma contorl
- Normal PFT
- Able to participate in activities
- No hospitalization or ED
- Correct medication use
- Asthma knowledge
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Use Findings to make recommendations
- Program service demographics
- Program cost/likelihood of reimbursement
- Program location
- Education level/language(s) of program documents
- Provision of medication
- Program personnel
- Transportation
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Identify Needed Program Resources
Funding, facilities, personnel, continuing education funding, equipment, patients
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Prioritize Program Features
- Based on resources and target population characteristics, determine:
- Extent of pulmonary function testing
- Patient severity
- Level of education- to provide/of the population
- Time for each patient for teaching
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What does evidence based mean?
Evidence based practice (EBP) requires that decisions about health care are based on the best available, current, valid, and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources
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What is PICO format?
- Patient/population/problem
- Intervention
- Comparison with other treatments
- Outcome
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Validated Program Evaluation Tools
- Asthma quality of life questionnaire (AQLQ)
- Standardised Asthma Quality of Life Questionnaire (AQLQ(S))
- Mini Asthma quality of life questionnaire (Mini AQLQ)
- Self-efficacy Scales
- Asthma Responsibility Questionnaire (AR)
- Pediatric Asthma Quality of Life Questionnaire (PAQLQ
- Adult and Childhood Asthma Control Test (ACT)
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Strategies to Improve and Assess Adherence
- Asthma education
- Reminders
- Routines
- Simplifying medication regimens
- Coaching
- Navigators/advocates
- Sharing decision making
- Motivational interviewing
- Assess applicable outcomes
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Program Influence on Participant's knowledge, skills, attitudes
- Evaluate outcome variables
- Use previously identified validated tools and medical outcomes
- Determine program successes and new goals
- CQI cycle: ASME standard 11
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Procedure and Tasking Implementation- Standardized Protocol
- History
- Physical Examination
- ACT for asthma control
- Medication and inhaler review
- PEF, spirometry, IgG, FeNO
- Written asthma action plan preparation/review/revision
- Patient's goals and concerns
- Consistent with ASME applications, standards 7 and 8
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Assess Program Outcomes (CQI)
- Use previously identified validated tools
- Compare measurement outcomes to identified program goals and patient outcomes
- Determine areas needing improvement
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Professional Partnerships
- Identify Community resources
- Provide education and technical assistance
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