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The Quality Improvement Support Collaborative: Working together!. Leslie Schultz, PhD, CPHQ, Director, Premier Healthcare Informatics. Why a Support Collaborative?. Challenge. Front line healthcare workers see themselves as relatively unsupported in their efforts to improve care.

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the quality improvement support collaborative working together

The Quality Improvement Support Collaborative:Working together!

Leslie Schultz, PhD, CPHQ,

Director, Premier Healthcare Informatics

  • 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.

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).

  • 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.
pilot collaborative improvement support projects
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).
information web sites
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.
reduce burden
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.
  • 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.
the qisc pilots
The QISC Pilots



louisiana qisc
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
la qisc goals of collaborative
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.
la qisc challenges
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
md qisc challenge of the local environment
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
quality improvement overload
Quality Improvement Overload
  • Get With the Guidelines
  • Guidelines Applied in Practice
  • National Registry for Myocardial Infarction
  • Crusade Registry
  • CMS 7th SOW (Delmarva)
  • And more…
md qisc goals of collaborative
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
status of pilots
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
challenges for the pilots
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

Leslie Schultz, PhD, CPHQ,

Director, Premier Healthcare Informatics 704.733.5209