Introduction

Multi-stakeholder Community Inventory Modules

Community quality collaboratives are community-based organizations of multiple stakeholders, including health care providers, purchasers (employers, employer coalitions, Medicaid and others), health plans, and consumer advocacy organizations, that are working together to transform health care at the local level. The Agency for Healthcare Research and Quality offers these organizations many tools to assist in their efforts.

Purpose of This Tool

The information gathered through the use of this inventory tool will provide your community with a foundation from which to identify resources, both human and financial, for each of the eight focus areas (listed below); leverage and align existing resources and activities; eliminate redundant efforts; and identify gaps and opportunities for collaboration. Through the Community Inventory, the Community Quality Collaborative will introduce the organization and its goals to a broader audience, enlist additional support, and form the basis for new relationships that may support the Community Quality Collaborative.

This tool describes why, when, and how it might be used, suggests who to contact in each of the eight focus areas, and what to do with the information once it is gathered. It includes eight separate modules, one for each focus area. Community Quality Collaboratives will select which modules apply to their strategies, goals, and workplans and use them to gather in-depth information. This tool also provides sample interview questions, evaluation tools to score the development of each area, and Web-based resources for each focus area.

This tool and companion process may provide value in a number of ways in addition to gathering baseline information on relevant past or ongoing activities. You may wish to record and communicate your findings in ways other than through the tables included in this document to capture the detail and content. The information gathered may be used in a number of ways, including updating and revising goals, strategies, tactics and workplans; guiding development of vision or mission statements; stimulating and informing discussions and brainstorming about challenges and innovative solutions; and pursuing resources.

The process of interviewing a diverse group of individuals will provide the opportunity to increase awareness of the Community Quality Collaborative and its goals, increase support for its goals across a broader constituency, gather diverse input and ideas from a broad base, and identify sources of financial or other resources.

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How to Use This Tool

It is expected that Community Quality Collaboratives will selectively use the modules in this tool, choosing those that apply to their goals and strategies and as they focus on a particular area such as "public reporting" or "provider incentives." It is expected that some Community Quality Collaboratives will use all eight modules.

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Why Use This Tool

The Community Inventory Modules are meant to guide communities in gathering detailed information for each of eight focus areas:

  1. Collaborative leadership.
  2. Public at-large engagement.
  3. Quality and efficiency measurement.
  4. Public reporting.
  5. Provider incentives.
  6. Consumer incentives.
  7. Strategy for improving quality.
  8. Health information technology (HIT)/health information exchange (HIE).

It is likely that your community has multiple activities with the same or similar goals, occurring simultaneously, and that key leaders either may not know about the others or have no incentive to consider the advantages for the community if they were to align their efforts with others. They may, in fact, be competing on quality goals when collaboration would greatly increase the overall value to the community. It is also likely that your community may be able to build on existing initiatives.

The modules also can serve as a record of findings to be used in planning future initiatives as well as be used to orient new members to the Community Quality Collaborative. This Community Inventory Tool will help your community gather the information from which your Community Quality Collaborative can develop an umbrella vision and strategy to align all disparate activities of multiple organizations for the benefit of the community.

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Getting Started 

When to Use This Tool

This tool should be used very early in your Community Quality Collaborative's formation process as Community Quality Collaboratives develop their workplans. Community Quality Collaboratives may choose to select those modules that are particularly relevant to their priorities for the coming year. Information gathered through the use of this tool will supplement the baseline information so that your Community Quality Collaborative will have a comprehensive and in-depth listing of relevant activities in your community.

You may want to set up a system of reminders to revisit specific programs, activities, or individuals at specific time intervals if they are relevant to specific goals or repeat certain aspects of the inventory periodically in rapidly evolving areas of inquiry.

The tool is meant to support strategic planning as well as specific initiatives or activities determined by your Community Quality Collaborative leadership or governing body.

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Establishing an Inventory Leadership Team

As you begin planning your strategy and identifying resources and expertise, you may wish to identify key individuals whose participation and leadership will lend credibility to your Community Quality Collaborative's efforts and who can provide access to information and individuals who could be helpful later on in the process. It is not necessary that every stakeholder be involved in every activity.

You may consider identifying an Inventory Leadership Team comprised of one leader for each focus area. The chart below illustrates the structure of a Community Quality Collaborative with projects in four focus areas and team members in each. Inventory Team Leaders should be top-level representatives or their designees who have a wide range of experience, relationships, expertise, and influence in the given area of inquiry. By scheduling regular update meetings/calls with the Team Leaders, the Community Quality Collaborative project director will provide built-in timelines and accountability for their completion of the process that should include completion of their respective modules included later in this document.

Inventory team leaders can form Focus Area Teams to help gather information. The Focus Area Teams should include individuals with expertise in the given field who can be objective and strategic in their inquiry.

Team leaders may share their team's results with the other team leaders and brainstorm possible strategic initiatives, areas of collaboration, and gaps to fill. Engaging multiple stakeholders with various perspectives and expertise will tap into multiple resources, facilitate learning across various stakeholders, and create a sense of ownership in building the inventory and subsequent strategies and activities.

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Information Gathering Process

Consider how information should be gathered early on based on the nature of what you want to learn:

  • Through presentations by specific individuals or organizations to a group of individuals if you want the information to be broadly disseminated and an exchange of information among key stakeholders.
  • By surveying multiple individuals in a given stakeholder group to quantify the extent of specific activities, knowledge, attitudes, and capabilities.
  • By conducting individual face-to-face or phone interviews for in-depth information, references, and brainstorming.
  • By reviewing public documents, conducting Internet research, or reviewing other resources for data and facts.

As the information is gathered, share the results of the inventory as broadly as possible to expedite knowledge transfer, spark ideas for areas of collaboration and synergy, and to identify gaps. Consider sharing the information in multiple venues with a variety of stakeholders.

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Information Sources

It is important to include all four stakeholder groups in your inquiry: (1) providers (including doctors, hospitals, nurses, medical societies, and others); (2) purchasers (both private employers and public purchasing entities, such as Medicaid, State employee programs, county employee programs); (3) national and regional health plans; and (4) consumers (including local advocacy organizations and chapters of national groups such as AARP, the American Diabetes Association, etc.). Each of these stakeholder groups includes a broad range of organizations and individuals. Consider which organizations within these stakeholder groups have and have not been involved in value-driven health care. For those not yet involved, this is an opportunity to get them involved.

The following table is meant to stimulate your thinking about who might be the most likely sources of information and resources for each focus area by organization type. You may want to identify the top two or three largest, most influential organizations in your community in each category and individuals within those organizations to start a list of potential sources of information.

Key Community OrganizationsEight Focus areas
Collaborative LeadershipPublic At-large Engagement.Quality & Efficiency MeasurementPublic ReportingProvider IncentivesConsumer IncentivesStrategy for Improving QualityHealth Information Technology/Health Information Exchange
Clinicians, physician groups        
Hospitals, health care systems        
Purchasers, employers, Medicaid        
Health plans        
Consumer advocacy organizations and individuals        
Quality Improvement Organizations (QIOs), other Quality Improvement (QI) organizations        
Labor        
Academia, researchers, state data organizations1        
Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIE)        
State, county, local government (regulatory)        
Public health agencies        
Foundations focusing on health care        
Pharmaceutical, device manufacturers        

1 Organizations that have partnered with AHRQ and contribute statewide data to HCUP, http://www.hcup-us.ahrq.gov/partners.jsp

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Community Inventory Tool Framework

The Community Inventory Tool Framework is structured around the Learning Network's eight focus areas described below. Through systematic review of each area of priority for a given Community Quality Collaborative, Community Quality Collaboratives can determine where best to start building their strategies and activities.

  1. Collaborative Leadership

    This focus area provides guidance on how to bring diverse stakeholders together to develop and implement a communitywide vision for improving health care quality and managing costs.

  2. Public At-large Engagement

    This focus area provides guidance for all Community Quality Collaborative stakeholders—employers, health plans, providers, and consumers—on how to increase public awareness regarding health care quality and costs and initiate change in social change in these areas.

  3. Quality and Efficiency Measurement

    This focus area provides guidance on issues related to collecting, analyzing, and using data on the performance of health care providers. Measurement is essential to determining whether and to what extent health care is improving and whether it is delivered efficiently.

  4. Public Reporting

    This focus area provides guidance on how to disseminate quality and cost information to the public. The benefits of improving accessibility to this information include permitting providers of health care to benchmark their performance against others, facilitating consumers' decision making, informing purchaser strategies to reward quality and efficiency and stimulating quality improvement activities in areas where performance levels are reported to be low.

  5. Provider Incentives

    This focus area concentrates on how to align financial incentives to reward high-quality, safe, and efficient care by physicians and hospitals.

  6. Consumer Incentives

    This focus area concentrates on helping health plans and purchasers identify and implement financial and nonfinancial incentives that motivate consumers to choose high-value health care providers and services.

  7. Capacity for Improving Quality

    This focus area provides guidance on how Community Quality Collaboratives can enhance their capacity to improve the quality of health care in their communities by creating a cohesive vision, leveraging existing efforts, and identifying ways to address gaps and expand outreach, most notably to small physician practices.

  8. Health Information Technology (HIT)/Health Information Exchange (HIE)

    This focus area provides guidance on how to use technology to collect, store, retrieve, and transfer structured medical information electronically. Health IT is seen as having great potential to improve the quality of care through enhanced coordination and continuity of care, as well as improved patient safety and fewer medical errors. In addition, increased administrative efficiencies, decreased paperwork, and lower health care costs may result.

The Community Inventory Tool includes eight modules that will help you assess each of the focus areas listed above. Each module provides you with guidance for completing it, including suggestions for resources you may need, individuals you may wish to contact, and suggestions on what questions to ask during an interview. Each of the eight modules is organized as follows:

  • Your goals in this inquiry.
  • Information you may want to gather.
  • Key individuals to contact.
  • Other individuals to consider contacting.
  • Suggested questions
    • Communitywide.
    • Stakeholder-specific.
    • Future community quality collaborative.

The people who complete each module will be asked to assess the focus area by identifying overlaps, gaps, opportunities, challenges, key leaders, and potential resources. They will also be asked to score the community's strength in their area to help identify opportunities for improvement.

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Current as of March 2009
Internet Citation: Introduction: Multi-stakeholder Community Inventory Modules. March 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/cimodules/cimodules-a.html