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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 2 0, 2011

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Community Quality Collaboratives: Accomplishments, Challenges and Opportunities

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  1. 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

  2. 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

  3. 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

  4. Study Methods • Selection of sample • Data collection • Key informant interviews • Documents and Archival Records • Analysis

  5. 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

  6. 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

  7. 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

  8. Key Findings: Activities and Accomplishments Building Trust among Stakeholders Rules for collaborating and competing Inclusive and transparent decision making Emphasis in the culture and operating practices on gradual change

  9. 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.

  10. Key Findings: Activities and Accomplishments Integrating into Local Health Community Partnerships with local private and public organizations

  11. Key Findings: Future Challenges and Sustainability Securing Financial Resources Threats to existing funds Opportunities for future funding

  12. 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.

  13. 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

  14. 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)

  15. Conclusion Important contributions to quality improvement Viability of current governance and management practices Strong leadership as a key attribute

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