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Clinical Care Quality
Clinical Care Quality
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the decentralized world of American health care, QIOs serve as catalysts of change,
working to translate nationally recognized best practices into local solutions.
QIOs are committed
to improving clinical care by implementing continuous quality improvement (CQI)
projects and programs.
Continuous Quality
Improvement (CQI)
CQI is based on
taking actions designed to produce measurably better outcomes. Typical measures
include:
- Development of
quality indicators-quantifiable measures of the process or the outcome of a medical
treatment or procedure.
- Collaboration
with physicians and hospitals that provide care related to specific quality measures.
- Baseline measurement
to determine the quality of current care.
- Analysis of the
baseline data, feedback and education of providers.
- Structured intervention.
- Re-measurement
of data.
- Evaluation to
determine effectiveness of the intervention.
Partners Critical
to Success
To be successful
in changing the behavior of providers and consumers, QIOs organize and put in
place community-wide quality improvement efforts in partnership with other key
stakeholders. Partners often include:
- Physician groups
and medical specialty societies.
- Hospitals and
other provider associations.
- Chronic disease
associations, such as the American Diabetes Association and the American Heart
Association.
- Federal agencies,
such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for
Healthcare Research and Quality (AHRQ).
- Managed care organizations
and insurance companies.
- Universities and
academic medical centers.
- State agencies,
such as Medicaid and state departments of health.
- Community agencies,
such as area agencies on aging, churches and senior centers.
- Consumer groups
and associations, such as the AARP and the Consumer Coalition for Quality Health
Care.
- Public and private
employers and employer groups.
Interventions
Each quality improvement
project employs a range of interventions focusing on both health care providers
and consumers.
Provider interventions
include:
- Creation and dissemination
of educational materials, such as letters, articles and seminars for physicians
and other caregivers. These often highlight "clinical pathways" or detailed
procedures for the care of patients with particular conditions.
- Periodic feedback
to providers and practitioners showing their performance compared to peer groups.
- Assisting in the
development of individualized quality improvement plans, measurement of progress,
and periodic plan updates.
- Support in the
development and dissemination of multidisciplinary quality improvement teams,
evidence-based guidelines, standing orders, critical pathways, treatment algorithms,
case management systems, documentation forms and other tools.
- Production and
distribution of tool-kits, which may include: flow sheets, sample guidelines,
checklists, reminder stickers for patient charts and tear-off referral forms.
- Development of
Internet or electronic-based data collection and tracking systems.
- Engaging opinion
leaders or other experts to foster change.
- Convening of coalitions
of disease-specific interest groups and organizations.
- On-site training
in quality improvement techniquesEstablishment of registries to receive adverse
events reports, analysis of incidents for patterns, advising hospitals on how
to prevent such events.
Consumer interventions
include:
- Consumer education
programs, health fairs, screenings, and immunization clinics.
- Mass media campaigns.
- Collaboration
with community organizations, churches, senior centers and pharmacies to promote
education.
- Targeted mailings.
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