Improving Quality Takes a Team; Technology Can Help

Primary care practices have more options for monitoring their clinical quality than ever before, through mechanisms such as EHR dashboards and payer data. While it’s true that advanced EHRs and robust measurement tools alone can’t guarantee that a practice will succeed under value-based programs, having access to these system can improve accountability and
transparency. But even with enhanced access to clinical measurement data and technology supports, the cornerstone to ongoing progress in clinical quality measurement—and consequently, to success in value-based payment—is often predicated on staff engagement, accountability and willingness to implement and adapt changes.  

Quality improvement should be viewed as a cycle rather than a static, linear process. Many organizations use methods such as the Plan, Do, Study, Act/Check cycle when taking steps to improve quality. If you are starting a QI initiative, consider the following: 

1. Plan. Think about your goal. How you will know if you meet it? What data do you need to collect? Keep your initial focus narrow so staff can concentrate on changing or improving a single
variable, rather than on overhauling an entire procedure. During this stage, it also helps to identify a measure or QI champion who will lead the change.  

2. Make changes. This is the action step, or “do.” QI is not the sole responsibility of the clinician; team and staff engagement are critically important to this process. When all staff
understand their roles and are ready and willing to implement changes, they are more likely to reach the goal. Celebrate small wins and milestones to encourage continued staff engagement.  

3. Study changes. As you make changes, document problems or unexpected consequences. Once a change has been implemented, collect data and analyze the results. Organizations with
successful QI initiatives often meet weekly or monthly to discuss and analyze results—reflecting on changes helps staff identify new opportunities for improvement. 

4. Adapt, Adopt or Abandon the Plan. After reflecting on what worked—or what didn’t work—the practice has options. Staff can adapt (make modifications and retest), adopt the change, test the change on a larger scale or abandon it (don’t retest). Quality improvement is a cycle; remember that changes will be made over time. 

When coupled with a strong team commitment to improving quality, timely access to clinical quality data can help practices monitor their current performance and adapt smoothly. Technology is one support of the QI cycle, but real improvement comes when a practice’s staff is working to understand and mitigate systemic issues that affect performance. 

• How does your organization engage staff in quality improvement? 
• Does your organization use any quality measurement tools or techniques? 
• How does technology support your QI efforts? 

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