Research over the past 20 years has established the effectiveness of a nurse home visitation program (NHV) in helping expectant and new mothers improve their knowledge of child health and development, build parenting skills, and improve their personal decision-making about education, employment, relationships, substance use, and other aspects of their lives. The NHV program is now being disseminated and replicated in public health settings throughout the nation at city, county, and statewide levels. One of the central premises of dissemination is that implementing the program with fidelity is necessary to reproduce in new sites the positive results achieved in randomized trials. In general, maintaining fidelity has been a problem when complex, experimental programs, like the NHV, move into larger scale replication. This presentation describes the development and use of a Clinical Information System (CIS) to promote high quality replication of the program. Based on data from three randomized trials targeting a variety of racial and ethnic populations, clinical data forms were developed for use by nurse home visitors. Sites enter local data into the CIS software and transmit files monthly to the National Center for Children, Families, and Communities in Denver which conducts analyses and provides regular feedback to sites on sentinel parameters of program implementation and clients' progress toward attainment of program goals. Key components of the CIS will be described and examples of analyses from selected dissemination sites will be presented to illustrate the quality monitoring capacity of the system and potential for assisting sites with program improvements.
Learning Objectives: 1. List the key components of a Clinical Information System (CIS) for monitoring and improving quality of program implementation. 2. Identify three examples of use of CIS generated data to design strategies to plan program improvements
Keywords: Quality Improvement, Information Systems
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Faculty member at University of Colorado Health Sciences Center supported by grants which have assisted with the development of the Clinical Information System described in this proposed presentation.