Document Type



The purpose of this quality assurance (QA) review is to improve the overall quality of the data collected and to enhance its use in Community Health Representative (CHR) Program planning. In fiscal year (FY) 1992, over 1,500 CHRs worked in over 260 programs, with 3.7 million client contacts, providing health education, transportation of patients, delivering critical medical supplies and prescriptions to clients, identifying and screening cases, leading health promotion and disease prevention programs directed to improve health, and a host of other services. The main objective of this project was to enhance to quality assurance of local CHR Programs reporting through: 1) targeted technical assistance efforts to improve the usefulness and accuracy of the data at all levels - tribal, Area, and national; 2) provide assurance training and technical assistance; 3) review Community Health Representative Information System (CHRIS II) coding rules and problems; and 4) assist local programs in using the data and Statement of Work for program planning purposes. The CHRIS II QA team conducted: 1) an analysis of database and source information used in research, reports, and other resources related to data necessary for program planning purposes; 2) prepared a report integrating prior findings; 3) identified information gaps for particular tribal programs and errors in implementing national CHR Program reporting rules; and 4) devised a set of study questions. These analyses were used to determine patterns of improvements and recurring problems in CHRIS II reporting across Indian Health Service (IHS) Areas. These analyses provided important background data on which to base site-specific data collection. The Project Team examined the different types of errors, and their evaluation indicated the extent of over- and under-reporting and the amount of data that are lost due to errors made in coding such as leaving the health area field blank or using invalid codes. The Project Team developed a protocol to use as a guide for on-site data collection that included the itinerary and data collection methods. Additionally, the Team also devised a data collection and analysis plan, and provided an on-site training and problem finding/recording protocol to various tribal CHR programs and Area CHR Coordinators.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857.