1. Institute for Clinical Systems Improvement July 2009 © 2009 Institute for Clinical Systems Improvement

2. Institute for Clinical Systems Improvement (ICSI) A collaboration of over 50 medical groups & hospital systems Sponsored by seven health plans Established 1993 Includes roughly 60 hospitals and medical practices with about 8300 physicians

3. ICSI Members (page 1 of 2) Affiliated Community Medical Centers Allina Medical Clinic Aspen Medical Group Brown Clinic Center for Diagnostic Imaging/Medical Scanning Consultants, PA CentraCare Chippewa County Montevideo Hospital and Medical Clinic Community-University Health Care Center Ear, Nose & Throat SpecialtyCare Fairview Health Services Family HealthServices Minnesota Family Practice Medical Center Fergus Falls Medical Group Gillette Children’s Specialty Healthcare Grand Itasca Clinic and Hospital Hamm Clinic HealthEast Care System HealthPartners Central Minnesota Clinics HealthPartners Medical Group & Regions Hospital Hennepin County Medical Center Hennepin Faculty Associates Hudson Clinic Hutchinson Area Health Care Hutchinson Medical Center Innovis Fargo, ND Lakeview Clinic Lake Region Healthcare Corporation Mankato Clinic Mayo Clinic

4. Marshfield Clinic Mercy Hospital & Health Care Center Midwest Spine Institute Minnesota Gastroenterology Multicare Associates New Richmond Clinic North Central Heart Institute North Clinic North Memorial Health Care NorthPoint Health & Wellness Center Northwest Family Physicians Obstetrics and Gynecology Associates Olmsted Medical Center Park Nicollet Health Services Paynesville Area Health Care System Planned Parenthood of Minnesota Quello Clinic Raiter Clinic Rice Memorial Hospital Ridgeview Medical Center River Falls Medical Clinic Riverwood HealthCare Center St. Mary’s/Duluth Clinic Health System Southside Community Health Services Stillwater Medical Group and Lakeview Hospital SuperiorHealth Center University of Minnesota Physicians Winona Health Services ICSI Members (page 2 of 2)

5. ICSI Sponsors Principal HealthPartners Blue Cross Blue Shield Minnesota Medica Associate Metropolitan Health Plan Preferred One UCare Minnesota Security Health Plan

6. Mission The mission of our collaboration is to champion the cause of health care quality and to accelerate improvement in the value of the health care we deliver.

7. Vision ICSI will be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by our community as a trusted voice for quality in health care.

8. ICSI Program Collaborative commitment cycle Scientific groundwork  Evidence based document development/maintenance of guidelines, protocols and order sets Support for improvement  Education & training  Member relations/coaching  Action groups & redesign collaboratives  Knowledge resources Consulting and product development

9. Requirements of Members Initial orientation & training sequence Collaborative commitment cycle Physician participation (and other professionals) in work groups & committees Critical review of guidelines/scientific documents Team-based continuous improvement Staff adequate to support the improvement A pattern of improvement over time Annual membership dues

10. 2008 Strategic Initiatives High Technology Diagnostic Imaging (HTDI) (06) Depression Improvement Across Minnesota, Offering a New Direction (DIAMOND) (06) Health Care Home (HCH) (08) Palliative Care (09)

11. ICSI Services ICSI services have long helped its members improve their quality, safety, culture and organizations Have contributed to ICSI’s reputation as upper Midwest’s leading health care collaborative ICSI now offers these proven services to non-ICSI members on a fee basis

12. ICSI Consulting Service Offerings ServiceOptions Culture of QualityWorkshops Collaboratives Speaking Depression CareCare Coordination Behavioral Health Integration Payment Redesign Motivational Intervention Decision SupportDiagnostic Imaging Payment Redesign Health Care HomeTeam Development Forming a Health Care Community Care Coordination Scripting for Patient Engagement Building a Quality Improvement Structure Building Consensus Rapid Cycle Improvement Adaptive Leadership Strategic Planning Facilitation SkillsProject Management Teaching Facilitation Skills Facilitating Your Team Project Speakers BureauTopics range from Health 2.0, and Patient Complexity to Adaptive Leadership and Disruptive Technologies Physician LeadershipSessions cover Leadership, Communications, Quality, Information Technology, Technical Skills and more Creating a Learning Collaborative This can be tailored to help implement any guideline/protocol clinical topics or system redesign topics

13. ICSI Options for SHIP interventions AA.ICSI membership - individual medical groups join ICSI and are committed to long-term membership vs. short-term focus just for the grant time period BB.ICSI Consulting services - ICSI develops and facilitates a short-term learning collaborative for the purpose of aiding groups in implementation of obesity and PPCD guidelines

14. A. ICSI membership Meet all ongoing requirements of membership in the ICSI collaborative Annual membership dues: $80 per FTE MD Participate in the current Cultivating Quality collaborative for building quality improvement infrastructure/systems

15. A. ICSI membership cont. There would need to be an additional charge for ICSI to build into the Cultivating Quality collaborative the focus on obesity and PPCD implementation as they are not current strategic initiatives at this time. ICSI is very interested in working with groups interested in implementing this work especially the focus on PPCD as it was a more challenging guideline for our pilot phase.

16. B. ICSI Consulting Services ICSI could put together a specific learning collaborative to focus on implementation of the obesity and PPCD guidelines through system redesign improvement work. The specifics of this could be worked out to meet the needs of your groups and the goals of the SHIP grant.

17. B. ICSI Consulting Services ICSI has created learning collaboratives for over a decade on clinical conditions, diseases, system redesign, and culture work. In addition to the implementation support, ICSI also provides goal setting, measurement support and ongoing education and training through the learning collaborative model.

18. Nancy Jaeckels, Vice President, Member Relations and Strategic Initiatives Nancy.Jaeckels@icsi.org 952-814-7070 Nancy.Jaeckels@icsi.org