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Why a Support Collaborative? . Challenge. Front line healthcare workers see themselves as relatively unsupported in their efforts to improve care.Meanwhile, a number of organizations see themselves as supporting improvement and seek to be more supportive.. Response. In December 2001, CMS, IHI, P
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1. The Quality Improvement Support Collaborative:Working together!
2. Why a Support Collaborative?
3. Challenge Front line healthcare workers see themselves as relatively unsupported in their efforts to improve care.
Meanwhile, a number of organizations see themselves as supporting improvement and seek to be more supportive.
4. Response In December 2001, CMS, IHI, Premier and VHA met to find ways of working together; in January 2002 they joined with JCAHO and NCQA to form the Quality Improvement Support Collaborative (QISC).
5. Goals Conduct pilot collaborative projects to support specific improvement goals.
Collaborate in providing information to support improvement.
Reduce the burden of data collection and quality improvement.
Make frontline providers more aware of ways in which QISC organizations and others can support them.
6. Pilot Collaborative Improvement Support Projects Heart attack and heart failure
Inpatient settings
Maryland and Louisiana (two States where QIOs,VHA and Premier were interested and capable).
7. Information & Web Sites CMS, IHI, AHRQ, Premier, VHA, JCAHO and NCQA run or are building web sites to support improvement.
To date -- few efforts to link support of improvement information.
The QISC organizations committed to collaborating to make web sites easier for frontline workers to use.
8. Reduce Burden CMS and JCAHO have converged their measures (a hospital collecting Oryx (JCAHO) measures can use them directly to participate in QIO (CMS) improvement efforts; CMS tools collect Oryx data.
All QISC organizations support the National Quality Forum effort to identify and endorse national measure sets for multiple settings.
9. Awareness Most hospitals are (vividly) aware of Oryx requirements!
They may be less aware of the existence of either regional or national programs supporting improvement activities.
10. The QISC Pilots
11. Louisiana QISC Background & Environment
118 Acute Care Hospitals in Louisiana
~70% JCAHO accredited and working on one or more core measure projects
NO legislative mandate on quality reporting
high utilization (Medicare expenditure) per hospital bed
12. LA QISC: Goals of collaborative Improve the quality of cardiac care provided to citizens of Louisiana.
Provide hospitals an opportunity to give input on national measures, given near inevitability of public reporting.
Contribute to an understanding of the real data burden involved in creating a public data set.
13. LA QISC Challenges Recruitment
requires individual soliciting - getting the right mix of players
hospitals concerned about added “burden”
Public reporting
working through the cycle of fear
14. MD QISC: Challenge of the Local Environment Public reporting already in place-administrative data and chart data
Regulated environment-MHCC, HSCRC, Office of Health Care Quality, JCAHO, Delmarva
Decreasing profitability
Increasing demand for accountability
Increasing resistance from hospitals for unfunded mandates
15. Quality Improvement Overload Get With the Guidelines
Guidelines Applied in Practice
National Registry for Myocardial Infarction
Crusade Registry
CMS 7th SOW (Delmarva)
And more…
16. MD QISC: Goals of collaborative Coordination: One coordinated project for chosen topic area
Burden: Commitment to use of existing data where possible and link to Core Measures
Linkage: Focus QI efforts on publicly reported measures
Executive Involvement: steering group composed of senior leadership
Cost/Benefit: Involvement of state rate setting agency
17. Status of Pilots LA QISC:
recruited “work group” from interested hospitals to provide input and direction in the planning of the collaborative;
first work group meeting scheduled for Feb. ‘03
first full collaborative group meeting anticipated in May ‘03
MD QISC:
recruited “steering committee” from interested hospitals to provide input to the type and nature of assistance the QISC could provide;
convening two work groups: a data management group and a “paying for quality” group
18. Challenges for the Pilots! Multiple quality agendas with pride of ownership
Too many cooks
Competitive environment
Uncertainty of what else “they” will dream up
Ability to maintain focus and momentum
Engagement of senior leadership and Board
19. Questions??? Leslie Schultz, PhD, CPHQ,
Director, Premier Healthcare Informatics 704.733.5209
leslie_schultz@premierinc.com