Even the best-performing healthcare providers can only do so much to improve quality and reduce costs without strong support and engagement from patients and communities. Regional Health Improvement Collaboratives help community members by understanding and actively engaging them in activities that will maintain and improve their health, showing them how to choose providers and services based on cost and quality, and supporting the delivery of higher-quality, better-coordinated care.
Read about NRHI members’, South Central PA and Maine Quality Counts, work in improving primary care in this article.
Hat’s Matter video. We all wear many discrete metaphorical hats — employees, parents, gym-goers — but all of these hats matter to clinicians when we start talking about health care. Watch this video from the Institute for Clinical System Improvement.
Read the Institute for Clinical System Improvement’s (ICSI’s) practical guide for facilitating conversations.
Listen to Lydia Paull-Flores, Senior Manager of the California Quality Collaborative, talk about her work in the community in this interview:
The family-care conversation is a procedure and if it isn’t done well there are adverse consequences. Physicians need training and education to strengthen their communication skills.
– Dr. Howard Epstein, Chief Health Systems Officer, ICSI
Listen to Jeff Biehl, President of the Healthcare Collaborative of Greater Columbus, talk about collaboratives:
- Empowering Patients. Massachusetts Health Quality Partners has developed tools that help patients effectively engage with their primary care physicians. These tools include ways that patients can communicate better with their physicians; parents can work with their physicians to improve their child’s health; patients can coordinate their own care; and patients can work with their physicians towards better health. To learn more about their work, visit www.mhqp.org
- Let’s Change (Commit to Healthy Activity and Nutrition Goals Every Day): See how the Common Table Health Alliance is making a difference! Through a partnership with the Shelby County Health Department, they are fighting childhood and family obesity by creating a culture of healthy living.
- The Oregon Health Care Quality Corporation (Q Corp) publicly reports health care information to consumers on the website www.PartnerforQualityCare.org. The information helps Oregonians become informed consumers of health care. Q Corp also has a patient engagement program, called Patients and Families as Leaders. This program supports healthcare organizations in Oregon that seek to actively engage patients and families in leadership roles. In its initial phase, Patients and Families as Leaders helped five health care organizations develop Patient and Member Advisory Councils. For more information about Q Corp’s Patients and Families as Leaders program, visit www.Q-Corp.org/our-work/patients-families-leaders. Q Corp also developed the performance measures for the Oregon Health Insurance Exchange to help people choose high-quality health plans.
- Massachusetts Health Quality Partners launched the Expect the Best Campaign to help patients know what they should expect when they have an office visit with a physician so they are more likely to get high-quality care. For example, patients are urged to “Expect that your doctor takes the time to give you clear instructions on what to do to take care of your medical problem, including what to do if your symptoms get worse or come back,” and patients are given specific suggestions as to what they and their doctor can do to make this happen.
- Partnering for a Better Patient Experience in Minnesota. In Minnesota, it took partnership to achieve the nation’s largest statewide patient experience survey. The Minnesota Department of Health partnered with MN Community Measurement to put together the comprehensive look at patient experience, which was released in November 2013. “Patients are going to get better experience and service because of this survey. A lot of doctors resist the notion this is a service industry, but it is. It actually does matter what my patients feel,” said David Satin, MD, then a member of MN Community Measurement’s measurement and reporting committee. Results from the more than 230,000 patient-completed surveys on patient experience of care—known as the Clinician and Group Surveys–Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS)—from 651 clinics were released in November 2013. This information can be used by consumers, along with other information on cost and quality, to make more informed healthcare decisions. The survey, emailed to patients after a medical clinic visit, focused on four areas of patient experience: whether patients are getting care when they need it, the helpfulness of office staff, how well clinicians communicate, and how well patients rate their clinicians. The data was collected in line with a 2008 Minnesota state law mandating clinics report their performance. This is just one of the many measures that providers report in Minnesota.The CG-CAHPS survey is the national standard for objective reporting of patient experience, allowing people to make apples-to-apples comparisons across clinics. Although there is room for improvement and results revealed a range of experiences, overall, Minnesotans report being happy with their care. Ninety percent of respondents described communication from their providers as top level, and 60 percent said they experienced the top level of access to care at their clinics. The majority of respondents also gave clinics top marks for being respectful and helpful.As a leader in health care transformation, MN Community Measurement was chosen to administer the survey and maintain the cache of survey results online. “Now that we’ve shown that we can have a statewide process and can get the information used, we expect this survey will be done every year or two,” said Jim Chase, president of MN Community Measurement. “Everyone benefits from this kind of data, and it’s sustainable because it will become a way things are done in our state. Our focus for the future will be how to make the survey process more timely and efficient and explore new ways to get the information used to improve care.” Research shows that good patient experience has a positive relationship to other aspects of healthcare quality, including patients’ adherence to providers’ instructions and outcomes. Although a patient’s choice of physician is deeply personal, this survey information can play a role in decision-making. “The way forward is quantitative reporting. It’s the main work of our generation of doctors,” said Dr. Satin.
- The Maine Health Management Coalition, in addition to its multi-stakeholder public reporting program, Pathways to Excellence, helped lead and support multi-year education and engagement programs for many public employers in the state. The curriculum included value-based purchasing principles, basics of quality measurement and reporting, and learning to use claims data to identify opportunities for improvement. With each employer, the labor-management groups ultimately agreed to significant changes in their health plan and benefit design and new relationships with local providers. These intensive programs were supported by community- wide efforts such as a Statewide Book Club aimed at learning about healthcare systems in other countries with a book tour by T.R. Reid. Over 14,000 people participated.
- Maine Quality Counts helps consumers become more involved in their health and health care through its programs and tools such as Better Health. Better Me! Guide, engaging patients and physicians in conversations about tests and procedures through the Choosing Wisely® Program, Maine PATHWAY to health brochure and the Maine Patient Centered Medical Home (PCMH)
- The Wisconsin Collaborative for Healthcare Quality created Wisconsin Health Reports, a patient-friendly website designed to help patients learn about their healthcare conditions, compare providers, and take action to improve their health.
- Pittsburgh Regional Health Initiative under the auspices of the Jewish Health Foundation has led an end-of-life (EOL) initiative called Closure that empowers consumers and healthcare professionals with easy-to-access information and resources to make educated decisions about end-of-life care.
- Find MI Care was developed in response to a community need for patients in Michigan to receive better coordinated healthcare treatment in an appropriate setting. Patients in Michigan looking for a doctor or other healthcare services can use the Find MI Care website and mobile application to search for clinics in their area and specifically in their region or zip code. Hospitals, physicians, and clinic staff are able to point out clinics near the patient’s home during the discharge process. Community groups can use this site to assist in connecting people in Michigan to healt care resources. In addition to improved care, the initiative is aimed at reducing use of ED services. Everyone deserves to have the right care, in the right place, at the right time.
- Race, Ethnicity and preferred Language (REaL) Data Collection: The Greater Detroit Area Health Council‘s REaL Committee is providing direction and strategies to ensure healthcare service organizations are standardizing the collection of self-reported REaL data to accurately identify and address disparities, and that consumers are aware of why the data is collected and how its use can improve care. A REaL toolkit with resources and training materials to help organizations improve the process and volume of data collection and a consumer focused Public Service Announcement- style video that organizations can utilize to support consumer understanding and engagement are available on the GDAHC website. The Real Public Service Announcement video can be viewed here.
- Hypertension Intervention Project (HIP) addresses the disparities in hypertension (high blood pressure) rates in metro Detroit’s African-American population. The GDAHC project focuses on improving blood pressure for patients by offering support for blood- pressure control and help with patient-doctor communication. There are two initiatives: (1) Create and share DVDs of patients sharing their own stories and tips to help patients learn how to take their medication, talk to their doctor and overcome other obstacles to improve blood pressure. (2)Work with providers and patients to identify and address barriers to blood pressure control associated with low patient health literacy.