Quality Improvement

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PERFORMANCE IMPROVEMENT

Community Care Network of Virginia’s vision for performance improvement is for continuous and sustainable performance improvement across three strategic goals:

  • Clinical Excellence
  • Operational Excellence
  • Financial Excellence

Clinical performance improvement via a traditional clinical quality improvement focus has been a hallmark of the provider community at CCNV since 1999.  However, because clinical, operational and financial outcomes are interrelated and cannot be impacted absent a systematic approach to performance improvement, CCNV has consciously broadened the scope and reach of its performance improvement efforts over time.

As the first statewide network of community health centers organized in the nation, CCNV has developed and is continually refining a state-of-the-art Performance Improvement Program capable of measuring, benchmarking and ultimately improving clinical, operational and financial performance forVirginia’s community health centers on a statewide level.

Community health center participation in the CCNV Performance Improvement Program supports local, statewide and national performance measurement initiatives including:

  • Benchmarking against other community health centers inVirginiaand against the Network aggregate score
  • Providing practice-level assistance with identification and targeting of patients for outreach, more intensive intervention or for overdue testing/follow-up
  • Assisting with compliance with UDS Measure Data
  • Supporting HEDIS and Patient-Centered Medical Home outcome measurement and analysis
  • Assistance with Meaningful Use
  • Delivering provider-level detailed performance reports within practices to assist Medical Directors in examining practice variations and identifying best practices
  • Providing data integrity analysis and assistance with electronic medical record data
  • Ongoing monitoring of electronic laboratory interface functionality and troubleshooting
  • Providing Network-level Best Practice identification and dissemination

CCNV’s Center for Data & Informatics provides the analytic support for the Network Performance Improvement Program and supports all dimensions of performance improvement – clinical, operational and financial measurement.  The Center for Data & Informatics processes data submitted by health centers; the Performance Improvement Program transforms data into information which can be integrated into a variety of process improvement models to drive decision making and to improve care and patient outcomes.

 CLINICAL EXCELLENCE

Community Care Network of Virginia sponsors a statewide clinical performance improvement program forVirginia community health centers via a provider-led Network Medical Management Committee, which dates to 1999.  The Network Medical Management program was established to promote consistent, high-quality care at practice sites across the Network.  The work of this statewide provider committee includes:

  • development of network-wide Clinical Practice Guidelines for high risk diagnoses;
  • dissemination, education and training to network provider staff on guideline principles and scientific evidence supporting “best practices”;
  • data collection to determine compliance with evidence-based guidelines;
  • targeted quality improvement interventions based on results of data collection; and
  • regular updating of the Clinical Practice Guidelines to ensure compliance with the most up-to-date scientific evidence and treatment recommendations

 Clinical Practice Guidelines have been created for diabetes, pre-diabetes and for four cardiovascular conditions (hypertension, cholesterol, stroke and obesity).  Network treatment goals have been established for each condition, and results of quality monitoring activities are compared with Network-wide treatment goals.

 Network providers representing each geographic region ofVirginia, as well as small and large multiple-site health centers are actively involved in all aspects of this clinical quality improvement effort.  Providers are responsible for the creation of the evidence-based guidelines, for the prioritization of clinical quality improvement efforts and for the analysis of clinical quality improvement data.  The work of the members of this provider committee is supported by the CCNV Quality Improvement Committee and the CCNV Board of Directors.

 Collection of data to measure compliance with the adopted Network treatment guidelines plays an important role in measuring success of both the adoption of evidence-based guidelines and any targeted quality improvement intervention deployed as a result of data analysis.

 Network Clinical Practice Guidelines (password protected)

OPERATIONAL EXCELLENCE

Operational targets for performance (such as visit cycle time and provider productivity) are interrelated with clinical and financial performance and cannot be studied and/or improved in isolation.  The Network Performance Improvement Program has integrated several operational measures of performance (such as visit cycle time) into the program’s ongoing performance improvement monitoring activities.

FINANCIAL EXCELLENCE

Similarly, financial targets for performance are interrelated with clinical and operational performance.  The Network Performance Improvement Program has also developed several financial measures of performance and has integrated these measures into the ongoing performance monitoring activities for the Network.