Community Quality Collaboratives: Accomplishments, Challenges and Oppo

Slide Presentation from the AHRQ 2011 Annual Conference

On September 20, 2011, Gary Young made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (135 KB). Plugin Software Help.


Slide 1

Community Quality Collaboratives: Accomplishments, Challenges and Opportunities

Community Quality Collaboratives: Accomplishments, Challenges and Opportunities

Gary J. Young, J.D., Ph.D.
Director and Professor
Center for Health Policy and Healthcare Research
Northeastern University, Boston MA

September 20, 2011

Financial support from the Agency for Healthcare Research and Quality

Slide 2

Overview of Presentation

Overview of Presentation

  • Study purpose and goals.
  • Methods.
  • Key Findings:
    • Activities and Accomplishments:
      • Improving quality.
      • Building trust among stakeholders.
      • Integrating within local health community.
  • Future Challenges and Sustainability:
    • Securing financial resources.
    • Maintaining cohesion among stakeholders.
    • Adapting to health reform.
  • Conclusion.

Slide 3

Study Purpose and Goals

Study Purpose and Goals
 

  • Focus on multi-stakeholder community collaboratives.
  • Select study sample from AHRQ Chartered Value Exchanges and affiliated collaboratives.
  • Investigate accomplishments, challenges, and opportunities.

Slide 4

Study Methods

Study Methods

  • Selection of sample.
  • Data collection:
    • Key informant interviews.
    • Documents and Archival Records.
  • Analysis.

Slide 5

Quality Collaboratives

Quality Collaboratives

  • Massachusetts Health Quality Partners.
  • Oregon Health Care Quality Corporation.
  • Integrated Healthcare Association (California).
  • Puget Sound Health Alliance (Washington State).
  • Health Improvement Collaborative of Greater Cincinnati (Ohio).
  • MN Community Measurement (Minnesota).
  • Wisconsin Collaborative for Healthcare Quality.
  • Indiana Health Information Exchange.

Slide 6

Key Findings: Activities and Accomplishments

Key Findings: Activities and Accomplishments
 

  • Improving Quality:
    • Activities:
      • Public provider reports:
        • Develop first community-based, consolidated quality report for physician organizations.
        • Expand reports to include patient experience and efficiency measures.
      • Best practice dissemination.
      • Payment innovations.
      • Guideline adherence.

Slide 7

Key Findings: Activities and Accomplishments

Key Findings: Activities and Accomplishments
 

  • Evidence of improvements:
    • Upward trends in quality measures (Chlamydia screening > 15 percentage points).
    • Reduced variation among providers.
    • Accounts of provider investments and practice change.

Slide 8

Key Findings: Activities and Accomplishments

Key Findings: Activities and Accomplishments

  • Building Trust among Stakeholders:
    • Rules for collaborating and competing.
    • Inclusive and transparent decisionmaking.
    • Emphasis in the culture and operating practices on gradual change.

Slide 9

Key Findings: Activities and Accomplishments

Key Findings: Activities and Accomplishments

  • Early on we recognized the need to lay out clearly defined rules about how quality data could be used... These rules have been used to keep stakeholders aligned and focused on the bigger picture of what is best for our community. Getting these kinds of issues on the table early on was really essential.
  • ...trust is something I earn one day at a time in each and every decision I make. You really need to demonstrate complete credibility and you do this by being sincere and completely transparent as to how decisions are made.

Slide 10

Key Findings: Activities and Accomplishments

Key Findings: Activities and Accomplishments

  • Integrating into Local Health Community:
    • Partnerships with local private and public organizations.

Slide 11

Key Findings: Future Challenges and Sustainability

Key Findings: Future Challenges and Sustainability

  • Securing Financial Resources:
    • Threats to existing funds.
    • Opportunities for future funding.

Slide 12

Key Findings: Future Challenges and Sustainability

Key Findings: Future Challenges and Sustainability

...putting out these public reports is a pretty big event. In fact, each [reporting cycle] is incredibly intense in the need to oversee so many procedures and details and deal with internal politics. I do think some people now see these reports as a routine thing; sort of like our state's report on vital statistics. But a big difference is that there is no national or state funding to support what we do. So, I feel intense pressure to identify new quality improvement opportunities that will attract attention and financial support.

Slide 13

Key Findings: Future Challenges and Sustainability

Key Findings: Future Challenges and Sustainability

  • Maintaining Cohesion among Stakeholders:
    • Tensions from collaborating and competing.
    • Contentious issues over future direction:
      • Addition of efficiency measures to public reports.
      • Inclusion of physician-level scores.

Slide 14

Key Findings: Future Challenges and Sustainability

Key Findings: Future Challenges and Sustainability

  • Adapting to Health Reform:
    • Opportunities:
      • Developing performance measures.
      • Reducing patient readmissions.
    • Challenges:
      • National data collection initiatives.
      • Internal decision making processes (e.g., consensus on clinically meaningful measures).

Slide 15

Conclusion

Conclusion

  • Important contributions to quality improvement.
  • Viability of current governance and management practices.
  • Strong leadership as a key attribute.
Current as of March 2012
Internet Citation: Community Quality Collaboratives: Accomplishments, Challenges and Oppo: Slide Presentation from the AHRQ 2011 Annual Conference. March 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2011/young/index.html