Bureau of Health Services, Tennessee Department of Health, Cordell Hull Building, 4th Floor, 425 5th Avenue North, Nashville, TN 37243, USA.
Matern Child Health J. 2012 Oct;16(7):1385-400. doi: 10.1007/s10995-011-0906-6.
To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management of the program.
描述一个评估系统的设计和实施，以促进全州范围内家庭访问计划的持续质量改进（CQI）和科学评估，并总结该系统在实现预期产出和短期结果方面的进展。“帮助我们成功成长”（HUGS）是一个全州范围内的家庭访问计划，为有风险的孕妇/产后妇女、儿童（0-5 岁）及其家庭提供服务。该计划的目标是提高育儿技能，使家庭能够获得所需的服务，从而改善服务人群的健康状况。评估系统旨在：（1）将评估纳入日常工作流程；（2）利用标准化的筛查和评估工具；（3）促进计划管理中的 CQI 文化；（4）促进科学严谨的评估。系统的设计和实施审查是通过形成性评估过程（范围、剂量和保真度）进行的。数据通过电子和纸质调查、管理会议记录和医疗图表审查收集。在设计阶段，选择了四个过程和四十个结果指标，并使用标准化的筛查和监测工具进行跟踪。在实施过程中，培训的范围和剂量足以成功推出评估/CQI 系统。所有员工（n=165）都使用该系统来管理家庭；主管（n=18）使用该系统来跟踪常规计划活动。数据质量和可用性足以支持在区域和州一级进行定期的计划审查。在最初的 7 个月里，HUGS 评估系统跟踪了 3794 个家庭（7937 人）。系统的使用和接受程度很高。在现有的大型全州范围内的计划中，成功实施具有强大 CQI 组件的结构化评估系统是可行的。评估/CQI 系统是推动计划管理适度变革的有效机制。
