Collaborative Quality Initiatives Continue to Influence National Care Protocols
By: Debbie Reinheimer
Since Blue Cross launched the Collaborative Quality Initiative model more than 20 years ago, our provider partners have routinely developed many best practices that improve clinical processes, safety and quality. The CQI structure enables rich data collection from a wide variety of clinical sites and fosters deep cooperation across the initiative. As a result, findings from CQIs are contributing to national knowledge, being adopted into national protocols, and influencing the way physicians practice across the country. Here’s a round-up of recent highlights:
Measures for diagnosing pneumonia and urinary tract infections receive National Quality Forum endorsements
Participants in the Michigan Hospital Safety Medicine Consortium, or HMS CQI, developed two quality improvement measures that earned National Quality Forum endorsements. NQF, in partnership with the federal government, plays a significant role in the creation of the national standards for measuring and publicly reporting clinical performance in various healthcare settings.
After a rigorous evaluation, the NQF multi-disciplinary committee granted endorsements of two quality measures developed by HMS. The measures focus on the appropriate use of antibiotics for hospitalized patients with community-acquired pneumonia and urinary tract infections.
Protocol for use of chest X-ray in children adopted by Choosing Wisely campaign
Data from the Michigan Emergency Department Improvement Collaborative led to the recommendation against performing chest X-rays on children who present to the emergency department with bronchiolitis, asthma, croup or first-time wheezing. In the MEDIC CQI initiative, 9,247 such chest X-rays were avoided over five years across Michigan emergency departments.
The long-running national Choosing Wisely campaign recently adopted this recommendation, and it became one of the first five recommendations to be made in the Choosing Wisely pediatric emergency medicine section.
Patient shares his story at national Urology meeting in Chicago. Patient perspectives – from MUSIC kidney initiative.
A patient advocate from the Michigan Urological Surgery Improvement Collaborative’s Kidney Initiative was selected to present during the Patient Perspectives forum at the annual meeting of the American Urological Association in Chicago. One of only a few chosen to participate, the patient shared his experience with kidney cancer and discussed how the MUSIC Kidney Roadmap for the Management of Patients with T1 Renal Masses helped him choose the best treatment for his situation and gave him the opportunity to improve his overall health.
Increasingly across the CQI portfolio of initiatives, Michigan physicians are engaging patients in better understanding their medical condition and active decision-making in which the patient evaluates treatment alternatives, computes the values of different alternatives, anticipates various outcomes, and explicitly makes a choice on their own.
Consultant Touts Use of MARCQI Tools and Reports for Quality Improvement and Cost Management
The Michigan Arthroplasty Registry CQI maintains unbiased registry information on the “revision risk” of the devices used in knee and hip replacements. A quality improvement consultant in orthopedics recently submitted a testimonial about MARCQI. This consultant provides expertise and advice to health systems and physicians nationally on reducing variation in care, lowering cost, and improving quality.
He said, “I have used the MARCQI registry tools, most notably the Summary of Arthroplasty report, as supporting literature to prod reluctant surgeons to consider changes where necessary. The fact that neither device makers nor industry venture capitalists sponsor it means the data are clean.”
He continued, “I have had considerable success lowering costs and reducing variation in the total joint reconstruction space. By a conservative estimate, I have been able to reduce costs by approximately $50 million. Because I can share the compilation of international registries and implant comparisons provided by MARCQI, it is much easier to effect changes that lower cost, reduce variation, and improve quality.”
This is yet another example of how the work of the CQI continues to engage providers, consumers, industry and academia in advancing the overall quality and safety of healthcare delivery.