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Quality Improvement Partnerships: The future of quality improvement Stephen Jencks, M.D.

Vision. The right care for every person every time.. Mission. CMS, QIOs, and Networks, by working with providers and practitioners, will make continuous and measurable quality improvement an ever-increasing part of the health care provided to Medicare beneficiaries.. Goals. We mustBe effective in

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Quality Improvement Partnerships: The future of quality improvement Stephen Jencks, M.D.

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    1. Quality Improvement Partnerships: The future of quality improvement Stephen Jencks, M.D.

    2. Vision The right care for every person every time.

    3. Mission CMS, QIOs, and Networks, by working with providers and practitioners, will make continuous and measurable quality improvement an ever-increasing part of the health care provided to Medicare beneficiaries.

    4. Goals We must Be effective in improving care Be efficient in improving care Accelerate the pace of improvement Be recognized for the value of our contribution to improving care Be a good program to work in

    5. Three Core (Branding) Strategies Work well with providers and practitioners Apply information systems Convene and promote partnerships

    6. Louisiana & Maryland Hospitals with the support of CMS, IHI, JCAHO, Premier, VHA.com. Details on what became possible because of QISC support that was impossible before.

    7. Quality Improvement Support Collaborative CMS, JCAHO, NCQA, Premier, VHA Cardiac NHQR materials Website coordination

    8. Imagine… A program in which local and national partnerships continually enrich our daily work and our strategic growth.

    9. JCAHO and CMS and NQF JCAHO and CMS Developed parallel, somewhat different measures. Hospitals went wild. JCAHO and CMS worked together to align measures and vet result through National Quality Forum. Result: one of the biggest single public relations wins for both JCAHO and CMS and major step forward for performance measurement

    10. Some Generalizations Partnerships have always been desirable, but many groups are now motivated to enter into informal and formal partnerships for which they would not have had time before. This radically changes the way we can think about our ability to get help and support from others. As the stakes for quality improvement rise, the need, and public demand, for coordination and partnership also rise.

    11. Hospital Associations: The Quality Initiative Associations wanted to develop voluntary reporting model. JCAHO had immediate reporting data but insufficient validation ability. CMS had ability to bring data in and place on website. Together a partnership to create a public reporting web site.

    12. IHI and CMS Operations IHI develops methods (Collaboratives, Pursuing Perfection, Impact, Move-Your-Dot) QIO-Network program applies and spreads these methods Three examples: BTS College, SIP collaborative, Networks Vascular Access Improvement Initiative Web site

    13. CDC and CMS The challenge and opportunity of culture gaps Virtual office PSTF SCIP Standing Orders

    14. Stratis and ICSI The challenge of bringing two “quality improvement competitors” into partnership.

    15. Surgical Care Improvement Partnership Aim: reduce surgical adverse events by 50% in 5 years. Partners: ACS, AHA, AHRQ, AORN, ASA, CDC, CMS, JCAHO, VHA.gov Three workgroups: measurement, best practices, propelling improvement. Pilots in Ohio, Oklahoma, Kentucky starting this month.

    16. Who Starts Partnerships? Local partnerships by each QIO. A QIO such as Qualis (for IHI Collaboratives) or MPRO (for the ACC collaboration) for national application CMS with QIOs as QISC-Louisiana-Maryland or SCIP-Kentucky-Ohio-Oklahoma CMS alone as CMS-CDC, CMS-JCAHO.

    17. Three kinds of Partnership Consensus (e.g.: CCP) Relatively low stakes for participants Cooperative (hospital measures, MedQIC-Qualityhealthcare.com) Very hard because it requires organizational compromises Collaborative (CMS-IHI) Complementary roles require better coordination but perhaps less compromise

    18. Motivation The most important reason a partnership succeeds is that leadership invests time and energy in making it succeed. The investment should pay off in efficiency, effectiveness, and respect from partners and customers. The investment should also pay off in a culture enriched by the perspectives of partners.

    19. What Are Our Goals? What activities would benefit from partners? What would we want the partners to do? What can we do to make participation a win-win? Partnerships that do not have a clear benefit are a waste of precious time.

    20. Selecting Activities for Partnership A preliminary plan requiring skills or strengths that are not QIO/Network core skills and are core skills of potential partners. One or more potential partners with the necessary skills that share the goal of the project.

    21. Making a Win-Win Common goals Roles consistent with individual skills/interests Remove or dissociate downsides

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