Quality Improvement Resources
Welcome to CHAMPS online quality improvement (QI) resources. This set of resources is intended to assist Region VIII Community Health Centers (CHCs) in becoming more familiar with the functions of quality improvement.
Note: This library of QI resources is a dynamic collection. CHAMPS staff welcomes new resources and any comments you wish to share. Please send resources and comments to Shannon@CHAMPSonline.org.
Please follow the links below for:
Brief History of QI in CHCs
Patient-Centered Medical Home and Meaningful Use
Links to Online QI Tools
QI Plan Assistance
QI Terms and Acronyms, Strategizing, and Decision Making
QI Related Webcasts
BRIEF HISTORY OF QI IN CHCS
Since the formation of CHCs during the 1960s, the goal has been to improve the health of underserved communities across the nation. In the decades following, questions were raised as to whether CHCs provided good health care. Literature on QI efforts in CHCs began to surface in the 1990s and CHCs became increasingly interested in learning how to continually improve services and demonstrate improved outcomes.
One of the largest QI undertakings in CHCs to date was the Health Disparities Collaborative™ (HDC). Initiated in 1998 by the Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC), in partnership with the Institute for Healthcare Improvement (IHI), the goal of the HDC was to improve health outcomes for all medically underserved people with chronic diseases. The Chronic Care Model (CCM) was utilized as the overarching model for the HDC. The CCM describes multiple dimensions that need to be addressed in order for health care services and patient outcomes to be improved; community resources and policies, healthcare organization, self-management support, decision support, delivery system design, and clinical information systems.
The HDC emphasized rapid Plan-Do-Study-Act (PDSA) cycles among other QI methods. CHCs were taught through learning sessions based on a learning and improvement model adapted from the Institute for Healthcare Improvement’s Breakthrough Series. The first HDC program focused on improving diabetes care.
Initially only five high-functioning health centers were chosen to pilot the HDC in 1998. By 2004, 497 CHCs were participating in the HDC. In addition to diabetes, the HDC focused on cardiovascular disease, asthma, depression, cancer, and the business case/redesign during the decade following 1998.
In more recent years, HRSA has encouraged PCAs to continue to support QI efforts in CHCs utilizing the methods and tools taught by the HDC as well as other QI methods. HRSA initiated the HIV/AIDS Cross Part Collaborative in 2008, and the Patient Safety and Clinical Pharmacy Services Collaborative in 2011. HRSA also formalized support for the Patient-Centered Medical Home (PCMH) and Meaningful Use models in 2011 to continue QI efforts in CHCs.
PATIENT-CENTERED MEDICAL HOME (PCMH) AND MEANINGFUL USE
Patient-Centered Medical Home (PCMH) principles and Meaningful Use (the adoption and use of electronic technology, including electronic health records, in a meaningful way) currently make up a large portion of QI activities in CHCs. Please see the following CHAMPS webpages for more information on PCMH and Meaningful Use including histories and backgrounds, definitions, trainings, tools and resources:
Patient-Centered Medical Home (PCMH) Resources
Meaningful Use Information and Resources
LINKS TO ONLINE QI TOOLS
Many tools and resources have been developed from the HDC and other QI initiatives over the years. Following are such resources that can assist CHCs with developing and implementing effective QI programs and activities:
Innovations and Quality Tools
www.innovations.ahrq.gov/innovations_qualitytools.aspx
Agency for Healthcare Research and Quality (AHRQ)
Provides over 600 innovations carried out by health care organizations including the problem addressed, description of the activity, and results, and also provides over 1,500 quality improvement tools including guides, toolkits, methods, and best practices to improve care
Integrating Chronic Care and Business Strategies in the Safety Net: A Toolkit for Primary Care Practices and Clinics
www.ahrq.gov/populations/businessstrategies/
Agency for Healthcare Research and Quality (AHRQ)
Informs safety net providers on how to redesign their systems of care along the lines of the Chronic Care Model while attending to financial realities
Knowledge Center
www.ihi.org/knowledge/Pages/default.aspx
Institute for Healthcare Improvement
Provides tools, change ideas, quality measures, white papers, audio, video, improvement stories, and more
Quality Improvement
www.hrsa.gov/quality/
Health Resources and Services Administration (HRSA)
Online resources including news, QI tools, leaders in quality, and a video forum
Resource Center
www.healthcarecommunities.org/content.aspx?id=223
Healthcare Communities
Web-based system that provides multiple means for the healthcare quality improvement community to share knowledge and contribute to each others’ QI work (formerly the Health Disparities Collaborative webpage)
Resource Library
www.improvingchroniccare.org/index.php?p=Resource_Library&s=159
Improving Chronic Illness Care
Offers a range of resources and tools designed for leading and managing improvement efforts within a variety of settings
Tools and Resources
www.pcdc.org/performance-improvement/tools-and-resources.html
Primary Care Development Corporation
Offers a host of manuals, guides, and toolkits to assist with primary care transformation including Translating Evidence Into Practice: A How-To Manual for Implementing Clinical Decision Support
QI PLAN ASSISTANCE
All CHCs should have a QI plan in place. Following is an excellent tool designed to assist health centers with assessment of the current QI plan, equip staff to revise the plan, provide a QI plan design with a description of each plan element, and assure all the necessary elements are contained in the plan:
Quality Plan Assessment Tool
Georgia Association for Primary Health Care
HRSA provides a series of archived presentations aired live in 2010 and 2011 on designing and implementing a successful QI program that meets CHC core program and FTCA requirements. The following series includes two sessions on designing and maximizing the effectiveness of a QI plan:
Quality Improvement and Risk Management Training
Health Resources and Services Administration (HRSA)
QI TERMS AND ACRONYMS, STRATEGIZING, AND DECISION MAKING
Please follow the links below for more QI resources:
Quality Improvement Glossary of Terms and Acronyms
Quality Improvement Strategizing
Clinical Quality Improvement Decision Making and Flows
QI RELATED WEBCASTS
CLICK HERE to find the following archived webcasts in the CHAMPS Distance Learning Library:
Managing Change Series: Empowering CHCs to Succeed
Session 1 – Change as a Process, 8/25/10
Session 2 – Roles within the Change Process, 10/6/10
Session 3 – Resistance to Change, 12/1/10
Customer Service in CHCs Series
Session 1 – The Culture of Customer Service, 6/10/09
Session 2 – Customer Service: The Art of Caring, 7/22/09
Change for the Better Series
Session 1 – Creating Positive Work Relationships: Tools for Increasing Trust and Building Commitment to Shared Goals, 10/4/07
Session 2 – Introduction to Ethical Influencing: Asking for What You Want and Making Behavior Requests, 12/5/07
Session 3 – Confrontation without Conflict: How to Address Difficult Issues Directly and Respectfully, 2/7/08
