How to make quality improvement science acceptable and successful in primary care Lessons from a 10 year project in Australia Andrew Knight April 2014.

Slides:



Advertisements
Similar presentations
Tools for Change Plan, Do, Study, Act The PDSA Cycle Explained
Advertisements

Addressing minority health access through community-based health literacy research Susan J. Shaw, Ph.D., University of Arizona.
ICTN PROJECT WEBINAR SERIES COMMUNITY HEALTH STUDENT PLACEMENT PROGRAM Presented By: Robyn Stringer, Judith Foley-Chell and Helen Johnson.
Improving Client Retention in Primary Care QI Project Review Title I Case Management HIV Quality Learning Network June 28, 2007.
Building Healthiest Communities By Aligning Forces For Quality (AF4Q) A Community Collaboration.
Presenter: Jennifer LoGalbo RHP 8 Monthly Learning Collaborative Call December 9,
The Olympic Team Trials: An Orientation to the Institute for Healthcare Improvement Breakthrough Series* Joe Kyle, MPH Kim McCoy, MPH, MS *some adaptations.
Quality & Safety Primary Care Knowledge Understanding, Discussion and Exchange Dr Dale Ford Dr Andrew Knight Improvement Foundation Australia Paris Q S.
Doris Duke Charitable Foundation African Health Initiative.
Te Wana Quality Programme Licensee – Healthcare Aotearoa. Jackie Richardson Te Wana Programme Manager.
Interprofessional Education and Practice: Creating Leaders and Opportunities for Clinical Learning MODULE 1 Overview of Programme and Participants Overview.
Sign up to Safety? Welcome to the webinar for Safety Improvement Plans You will be muted on entry so we reduce background noise.
Patient Safety and Clinical Pharmacy Services Collaborative (PSPC)! Karen C. Williams, MBA, PharmD Office of Pharmacy Affairs Health Resources and Services.
QUALITY IMPROVEMENT COLLABORATIVES Kupu Taurangi Hauora o Aotearoa.
Creating a service Idea. Creating a service Networking / consultation Identify the need Find funding Create a project plan Business Plan.
Produced by The Alfred Workforce Development Team on behalf of DHS Public Health - Diabetes Prevention and Management Initiative June 2005 Engaging Pharmacists.
ORIENTATION SESSION Strengthening Chronic Disease Prevention & Management.
Publishing your work is necessary but not sufficient for wider research impact Libby Kalucy Editor in Chief, Australian Journal of Primary Health 9 August.
Chronic Disease Management: Driving Quality Improvement in Primary Care August 1, 2008 Jan Norman, RD, CDE Washington State Department of Health.
Insert name of presentation on Master Slide Professor Sue Lister Introducing quality improvement into the education of health and social care professionals.
Closing the Indigenous health gap & evaluation: getting it right and making an impact Professor Ian Anderson.
Decreasing births < 39 weeks gestation without medical indication and improving birth registry accuracy project Creating Your Team Storyboard Instructions.
Presentation to New York State Academy of Family Physicians Scott Wooder, MD Chair OMA Negotiations Committee January 31, 2009.
Nursing Research Capacity Building. Background CON –opened as 9 th College at SQU in 2008 The CON’s next challenge is promoting nursing care based on.
Supporting NHS Wales to Deliver World Class Healthcare All Wales Stroke Services Improvement Collaborative Learning Session One 21 st October 2009.
Aligning the Workforce to Organisational Values & Behaviors Chris Belcher, George Eliot Hospital Trust.
CTxCPCRN Central Texas Cancer Prevention and Control Research Network Kick Off Grantee Meeting Atlanta, Georgia October 15-16, 2009.
Proposed changes to how practices are funded to manage people living with Long Term Health Conditions.
Western NSW Integrated Care Strategy To transform existing services into an integrated Western NSW system of care that is tailored to the needs of our.
Chapter Quality Network (CQN) Asthma Pilot Project Team Progress Presentation State Name: Ohio Practice: Toledo Children Primary Care Team Members:
An Introduction to Improvement. To develop a basic understanding of: Service improvement in healthcare Some of the tools and techniques used To apply.
The Knowledge Network: supporting education and practice Derek Boyle Knowledge Services Group NHS Education for Scotland November 2014.
S.A.F.E Situation Awareness For Everyone
Surgical Care Improvement Project QSource Hospital Quality Improvement Team Spring 2008 THA Patient Safety Center “Reducing Hospital Acquired Infections”
Welcome Alberta Screening & Prevention Initiative Improvement Facilitator Training Session 2.
National Primary Care Development Team Phase III Penny Gates Lead Manager SW Peninsula NPDT Centre.
Challenges to successful quality improvement HAIVN 2013.
Improving Clinical Processes: The Million Hearts ® Hypertension Control Change Package for Clinicians Erica K. Taylor, PhD, MPH, MA Million Hearts ® Minority.
European Social Fund Promoting improvement Shirley Jones.
1 Evaluation of Patient-Centered Medical Home (PCMH) Initiatives Meredith B. Rosenthal, PhD February 24, 2009.
1 Prevention, Reablement & Integration. 2 Background We are at an historic time for social care. We have a health and care system too focussed on crisis.
Using Multiple Data Sources to Understand Variable Interventions Bruce E. Landon, M.D., M.B.A. Harvard Medical School AcademyHealth Annual Research Meeting.
Name of presentation Improving health in Greenwich: Linking integrated health & social care with primary care.
Health IT for Post Acute Care (HITPAC) Stratis Health Special Innovation Project Candy Hanson, BSN, PHN December 5, 2012.
Introducing Improving Quality Together. Purpose Improving Quality Together aims to support a change in mindset in NHS Wales, where each individual demonstrates.
The Model for Improvement Kevin Gibbs. 1. Redesigned care processes 2. Effective use of information technologies 3. Knowledge and skills management 4.
Group Health’s experience September 24, 2015| Kathryn Ramos Implementing CDSME in an integrated health care system.
The Primary Health Care Access Program (PHCAP) in the Northern Territory. John Boffa Public Health Medical Officer Central Australian Aboriginal Congress.
The Learning Collaboratives at PDI Leads Workshop Wave Hill March 25, 2014.
Northwestern Family Medicine Residency & Erie Family Health Center
Reforms: Diabetes West
/ HUSH Project Clinical Lead
Proctor’s Implementation Outcomes
[Your Facility Name] is now a member of Passport to IHI Training!
Quality Improvements.
Local Health Network Consumer and Health Advisory Councils
Poster 1. Leadership Development Programme : Leading Cultures of Research and Innovation in Clinical Teams Background The NHS Constitution is explicit.
Communications Study Day
What is a Learning Collaborative?
Having patients set self-management goals will improve care.
Building a Digital Ready Workforce
Centre for Disability Studies
Having patients set self-management goals will improve care.
Introduction to Quality Improvement Methods
NQIP – NELFT Quality Improvement Programme
CITE THIS CONTENT: RYAN MURPHY, “QUALITY IMPROVEMENT”, ACCELERATE UNIVERSITY OF UTAH HEALTH CURRICULUM, JANUARY 30, AVAILABLE AT: 
Building Capacity for Quality Improvement A National Approach
The Context Dr Brian Robson Medical Director NHS QIS
CROATIAN HEALTH INSURANCE FUND
CITE THIS CONTENT: RYAN MURPHY, “QUALITY IMPROVEMENT”, ACCELERATE UNIVERSITY OF UTAH HEALTH CURRICULUM, JANUARY 30, AVAILABLE AT: 
Presentation transcript:

How to make quality improvement science acceptable and successful in primary care Lessons from a 10 year project in Australia Andrew Knight April 2014

Conflicts Clinical Advisor to the Improvement Foundation Shared funding to attend between IF and role as staff specialist Acknowledgements The Australian Primary Care Collaboratives program is funded by the Australian Government and conducted by the Improvement Foundation Colleagues – Dale Ford and many others who have contributed since 2004.

Plan 1.Explain what we have done The problem The selected solution What happened Lessons 2.Ask you reflect and discuss Are there lessons for your health system?

The Problem 1.Strengthening primary care…but how? 2.General Practice in Australia 85% of population per year (March 2013) 6.57 visits on average 2.44 million encounters per week 7035 practices (2011) First contact, gatekeeper No contract, universal insurance Fee for service and some process incentives (10% income)

Reflection Does your primary care system resemble ours?

The Solution Quality Improvement Collaboratives ‘A Breakthrough Series Collaborative is a short-term (6 to15 month) learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area.’ IHI White Paper.

Breakthrough Collaborative Series 6

What we did Small teams - 18 months 3 workshops – aims, evidence, improvement, change principles, measures Activity periods – PDSA cycles, measures, Monthly reports and cohort comparisons Local support Sharing of ideas

What happened Based on NPDT, Sir John Oldham Transferred 2004 and we are still doing it Multiple overlapping cohorts - national Total services participating 1949 (unique 1230 approx. 18% of total) Diabetes registers CHD registers COPD registers PDSAS 36000

What happened Access, diabetes, CHD Prevention COPD Patient self management Diabetes prevention Aboriginal health E health Quality Improvement training Chronic Kidney Disease Patient safety Cancer screening

What happened Local workshops –206 health services joined one of 15 locally based QI Collaboratives delivered by their support organisation. Virtual workshops- 60 health services joined one of four online QI Collaboratives delivered by IF. Medicare Local QIP health services joined their Medicare Locals in locally based QI workshops delivered by their Medicare Local.

What happened –Hba1c Mean percentage of patients with an HbA1C ≤ 7% n-743

What happened – HbA1C recorded Mean percentage of patients on register with HbA1C results recorded

What happened – cholesterol in CHD Mean percentage of patients with cholesterol at target

What happened – spirometry in COPD Mean percentage of patients with spirometry recorded

What happened – system change Data extraction tool Data management portal Culture change knowledge, skills, attititudes Spread National KPI reporting Aboriginal medical services

Lessons - transfer Not for profit Independence, nimbleness Adjust to local needs…politics Rigour structured sharing of intellectual property Expensive

Lessons - Evaluation Built (budgeted) from the start Publish Knight AW, Caesar C, Ford D, Coughlin A, Frick C. Improving primary care inAustralia through the Australian Primary Care Collaboratives Program: a qualityimprovement report. BMJ Qual Saf Jul 18. Knight AW, Ford D, Audehm R, Colagiuri S, Best J. The Australian Primary Care Collaboratives Program: improving diabetes care. BMJ Qual Saf Jun 16.

Lessons - QICs One collaborative Short sharp effective Achieve improved care Provide training in improvement TEND to MEAN Many collaboratives Changed culture Increased capacity Changed expectations SUSTAINABLE CHANGE? NOT ENOUGH

Lessons - QICs What works? Importance of team In the literature (Ovretveit) In Australia Team principle Right topic Local support

Lessons - QICs Engage with many small organisations Known and trusted Builds capacity Adaptable Limited

Lessons - QICs Practice Context Charlotte Hespe

Reflection Would it work in your primary care system? Introduce yourself to some people you don’t know Share your reactions to our experience What would work What wouldn’t work What will you try