Let’s start by going over what we mean by the term clinic gap analysis. The phrase Gap Analysis generally refers to a systematic and deliberate process of examining the needs of a population and identifying gaps between what the population needs and what a program can provide. This module discusses how to conduct an analysis of two separate areas: assessing their patients’ needs and also assessing provider competency in EBPs.
For collecting information on patient needs, we cover two relatively easy methods for obtaining this type of data. The first method involves collecting and analyzing information stored in the electronic medical records. The second method involves directly assessing patients’ needs through the use of a quick questionnaire. This type of information can be beneficial in helpful in planning and measuring the effectiveness of process improvement projects, as well as other areas, which are highlighted in the callout box to the right.
Using archival data to assessing patient needs: A large benefit to having an electronic medical record system like GENESIS/AHLTA is that the system stores information about appointments that can be easily accessed. One method for obtaining existing data is to request key data elements from your M2 POC at the hospital or MTF. The Toolkit has an instruction guide entitled “Clinic Level Reports in Excel .” This document will walk you through the process of requesting this data and how to input that data into an excel file to be analyzed. This document walks you through how to obtain and graph data on types of diagnoses in your population, wait times, etc.
If you cannot obtain data from your MTF’s M2 POC, there is an alternate method for getting some of the same information, which does take more time, but yields similar results. You can see step-by-step instructions for getting this type of information out of AHLTA in the Toolkit Handout: “Steps to Collect AHLTA Data .” The handout also provides directions on how to enter the data from these reports into an Excel spreadsheet that is included in the toolkit. This spreadsheet will help you organize this information and examine trends over time using simple graphing functions.
Using patient completed forms to assessing patient needs: In addition to examining archival data regarding patient diagnoses, clinic leaders can use a form that asks patients in plain language what current issues or problems they are experiencing. The Clinic Gap Analysis: Patient Form is a one-page paper and pencil form that screens for common diagnoses and asks about common problems like stress or anger. We recommend incorporating this form as part of the intake paperwork a patient completes for a period of 1-2 months to get an adequate sampling of your population. There is also an associated spreadsheet for entering the results, which automatically generates useful summary graphs of the data to examine your patient population’s needs. This spreadsheet will allow you to determine the number of patients with each issue or potential diagnosis. You will also gain a more in-depth understanding of the disorders. For example, for PTSD, you can see what percentage is due to combat vs. non-combat. You will also have information on the easiest times for patients to come to the clinic, which can be very helpful if you are planning on starting EBP groups to address patient needs.
Conducting a gap analysis of the patient population gives you a clear picture of the demand side of the equation, but you will also want to assess the supply side; What treatments are your providers able to deliver? To help assess provider EBP training and utilization, the toolkit contains a form entitled “EBP Training and Utilization Questionnaire ” to help answer the following questions:
- How many providers have been trained in the various EBPs for PTSD, Depression and Insomnia?
- Have they practiced the EBP since the training?
- Have they received formal consultation?
- How often are they using the EBP in their practice?
This form takes only a few minutes to complete and is meant to be given quarterly. The information from the form allows clinics to see the levels of training and use of EBPs, as well as track changes in these metrics over time. The toolkit also has a spreadsheet for analyzing the results and an instruction guide for scoring the questionnaire and entering the data into the associated spreadsheet. Lastly, the module has a template for a standard operating procedure that covers the process of using the Provider EBP Training and Utilization Questionnaire, covering all tasks from passing out the questionnaires to reviewing the data after it has been entered.
Relevant toolkit items: Patient-level Metrics
| Item Name | Description | Audience |
|---|---|---|
| Conducting a Clinic Gap Analysis Slides (PDF) Slides (PDF with notes) |
Training presentation on the benefits and logistics of conducting a clinical monitoring assessment in a military behavioral health clinic | Clinic Managers |
| Clinic Gap Analysis: Patient Form | Customizable form to administer to patients to ascertain services needed in the clinic | Patients |
| Clinic Gap Analysis: Patient Form Spreadsheet Template | Spreadsheet for clinic manager to aggregate data from the “Clinic Gap Analysis: Patient Form” | Clinic Managers |
| Steps to Collect AHLTA Data | Step-by-step instructions for clinic managers to pull data on total number of appointments, most prevalent diagnoses, and type of care (individual, group, psychiatry) from AHLTA | Clinic Managers |
| AHLTA Clinic Gap Analysis Spreadsheet Template | Spreadsheet for clinic manager to aggregate total number of appointments, most prevalent diagnoses, and type of care (individual, group, psychiatry) from AHLTA data pull described in “Steps to Collect AHLTA Data” handout | Clinic Managers |
| EBP Training & Utilization Provider Questionnaire | Questionnaire to be completed by providers to ascertain training and utilization of common EBPs for PTSD, depression, and Insomnia | Providers |
| Instructions for Administering the EBP Training & Utilization Provider Questionnaire | Handout with instructions for administering the EBP Training & Utilization Provider Questionnaire, as well as using the associated tracking sheet to enter the data | Clinic Managers/ Staff |
| EBP Training & Utilization Spreadsheet | Spreadsheet for entering data from the EBP Training & Utilization Provider Questionnaire. The spreadsheet includes auto-generated graphs to help with data analysis | Clinic Managers |
| SOP/OI for Administering the EBP Training & Utilization Provider Questionnaire | Template for clinic managers to use in order to establish procedures for regularly administering the EBP Training & Utilization Provider Questionnaire. Data from this will be used to guide clinic-level decisions | Clinic Managers |
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