AFISE Baylor Romania – Planning and Measuring Quality

Baylor Romania – Planning and Measuring Quality for Infectious Diseases and Community Services Background Quality indicators are as important as the quantitative ones, when delivering social/medical services and working with patients. The quality indicators are relevant for identifying potential quality concerns, emphasizing areas that need further study and investigation, and track changes over time. Quality measurement of Baylor Romania’s services is a constant focus for the M&E department, since we are aware that the quality of our services has a direct influence over our patients’ health and indirectly over the community’s health on the long term. The interest for measuring quality is relevant worldwide, and social scientists have developed various theoretical frameworks. One such model that presents social quality has been developed by the “European Foundation on Social Quality” as a result of an international project. The resulting document “Indicators of Social Quality: Outcomes of the European Scientific Network” was written by Laurent J.G. van der Maesen and Alan C. Walker. Objective To provide a guideline for evaluating Baylor Romania’s services from a quality point of view. Methods In order to exemplify the quality indicators used by Baylor Romania we’ve analyzed how the psychosocial department is functioning, since the situation is similar for other departments within the organization. The psychosocial department was analyzed from two perspectives: « internal procedures aiming to ensure alignment with the mission statement – these are regulations and standards that were either developed by the organization or that were already established at the national level. The internal procedures are ensuring a common approach in providing direct services by all personnel involved « quality indicators set for HIV care – these are basically social indicators that intertwine theoretical and practical approaches used in HIV psychosocial care In order to describe the quality indicators, we’ve adapted to our organization the framework presented in the “Indicators of Social Quality: Outcomes of the European Scientific Network”. This is a model of social quality developed by the “European Foundation on Social Quality” as a result of an international project. The document’s theoretical approach to social quality was used to analyze all the documents, procedures and indicators used and established for the psychosocial department in order to identify their quality relates dimensions. According to this model there are four basic areas that determine the social quality of one’s life; all these areas highlight the connection between the person and the society:   Social empowerment – people’s capability to interact and to use their abilities in social relations;   Social inclusion – the accessibility and integration into different institutions, social relations, etc;   Socio-economic security – is a measurement of access to resources over time;   Social cohesion – are necessary collective accepted values and norms that enable community building. Results In accordance with the model proposed by the guiding document the social quality was defined as the extent to which Baylor Romania’s services succeed to support HIV infected and affected people in taking informed decisions concerning their health, social and economic life as well as enhancing their individual potential, by addressing their needs through an individualized approach. Two quality care dimensions were identified based on the analysis of Baylor Romania’s psychosocial department: quality indicators, which involve measurements and data collection (therefore a more “static” dimension) and procedures which ensure constant high quality interventions within the organization (the “dynamic” dimension). The quality indicators which were identified followed the following categories: social empowerment, defined as health empowerment, social inclusion (labor market, services, citizenship rights, etc), social economic security (financial resources, housing and environment), social cohesion (responsibility). The final goal of all the activities reflected in these indicators is to have informed and skilled beneficiaries, able to deal with the various tasks and challenges they face in their social network, while keeping their independence and ability to exert their rights and responsibilities. The procedures analyzed were part of the common approach towards beneficiaries from all personnel involved in providing direct services, offering guidance, structuring the intervention and representing the link between the vision of the organization, the theoretical psychosocial approach and the specialist. Below some examples are listed:   Annually updated psychosocial standards, clear and flexible distribution of responsibilities on each case for every team member;   Weekly multidisciplinary team meetings for case-studies discussions;   Constant development of instruments and tools in order to cover the majority of social situations re- questing interventions, electronic psychosocial data base;   Regular update of the information delivered through printed materials or during counseling in order to integrate new discoveries from HIV area or new information requested by beneficiaries;   Services delivery contracts used for all beneficiaries accessing Baylor services. Conclusions Both dimensions, the static and the dynamic ones, are necessary, allowing the double approach to quality from both the results/impact and procedural point of view. They sustain one another. How this is actually implemented depends on the organization’s culture, vision, local environment and social background. The focus on quality requires time to be established and it is a necessary step in the dev [Y[وBܙ[^][ۈ[][\K]]܎HZZ[HY[XKBBBBB\ܘ[\\X܈ BBBBBBP^[܈X[XBX[ܘ\N8'[X]ܜوX[]X[]N]Y\وH]\X[Y[YX]ܚ'HH]\[ˈ[\XY\[[[[ˈ[\