Problem: Due to suboptimal performance in key ACO quality measures and the growing need for quality improvement (QI), Greater Roslindale Medical and Dental Center built and implemented a quality program from the ground up. In turn these strides transformed their practice by integrating QI into the culture of the organization.
Measurement: Many best practices emerged to measure performance process improvements such as health care data analytics and the use of various tools including: root-cause analysis, Plan-Do-Study-Act model, and workflow templates. Driver diagrams were used to develop dashboards to monitor cancer screening and chronic disease management.
Analysis: Monthly and TY data helped analyze performance trends. Patients were prioritized based on conditions (single measure vs multiple measure gaps). Outreached and chart audits identified reasons behind gaps of care and barriers. Follow-ups were made for those who had less probability to meet measures. Gap lists were closely monitored.
Implementation: Priority measures were set for the CHC using dashboards with a focus on chronic conditions, preventative measures, pre-visit screening, well-child visits & immunization, and infectious disease. Tools employed by QI were the use of PDSA cycles, dashboards, and collaborations, which were critical in determining whether processes needed to be refined.
Results/Discussion: Several key themes were found to be crucial for sustainability, including active/consistent communication, accountability, the will to embrace change collectively, support from BMCHN, and the importance of using data to make drive decision-making. These successes are promising; the long-term influence of the CHC QI program will significantly impact health equity.