CHALLENGES OF THE PATIENT VISIT REDESIGN EVALUATION

Abstract

This paper describes an evaluation design to be utilized for a Quality Improvement project, Patient Visit Redesign. A theoretical framework from the Quality Improvement principles is employed to describe the concepts of improvement and evaluation. The history of the Quality Improvement movement is described as part of the theoretical framework combined with the principles of Reengineering and Utilization -Focused evaluation. The outcomes focused evaluation design follows the six step cycle of the US Public Health Service model. The project, which was implemented in a large, urban Community Health Center women's clinic, is extensively detailed together with the methods of evaluation. Challenges that were encountered by the internal evaluator during the design phase of the evaluation included formation of an evaluation team, dealing with bias and politics, requiring notification of subject rights and management pressures. The recommendation of the author is to conduct the evaluation every quarter in order to establish routinization, as a process for Quality Improvement, and to deal with changes in a timely manner.