|1. A quality improvement program for mental health care is in place.
- A quality improvement plan is in place for mental health services which includes:
- Documentation of a quality improvement plan for evaluating care;
- Indicators for quality that are clearly identified and measured on a regular basis; and
- Performance data that is followed over time.
|2. A process for quality improvement is in place.
- Evidence of quality improvement activities exists to deal with opportunities for performance improvement, including:
- The program's response to monitoring and/or evaluation data; and
- Performance data that is communicated back to relevant staff.
- There are clear lines of accountability established for implementation of quality improvement strategies that include the following:
- Responsibility for managing implementation of quality improvement efforts;
- How the program is multidisciplinary;
- Response and feedback from management to QI recommendations;
- All levels of the organization are made aware of lines accountability for quality improvement activities; and
- Staff receives training on quality improvement.
|3. A systematic approach exists for ongoing data collection & evaluation to set priorities, plan changes in program design, study and monitor processes, and sustain improvements.
- The organization conducts monitoring and evaluation on performance based criteria that includes:
- Type of monitoring/evaluation in place;
- Identifying who conducts the monitoring and evaluation; and
- The methods of monitoring: medical records, computerized programs, etc.
- The agency monitors the overall rate of medical and mental health adherence and uses the information to modify or develop program strategies.
- The program meets or exceeds the projected number of clients served and number of services provided annually.
|4. Structures are in place for HIV consumer involvement and active participation in the development and quality improvement of the HIV mental health program.
- There are mechanisms for consumer input to the mental health program itself and not just the overall agency consumer involvement plan.
- There are written policies and procedures for consumer participation, including information on the frequency of the activities.
- Consumers of mental health services participate in the development and improvement of the mental health program through advisory committees, focus groups, consumer satisfaction surveys or other opportunities.
- Client identified issues are integrated into the agency's quality improvement process.
- Results/recommendations are reported back to management.
- Management's response is documented.
- Feedback on recommendations is provided to staff, committee/group members and other consumers.