Reform in Action: Improving Quality in Medical Offices

Insights from Aligning Forces for Quality

The National Committee for Quality Assurance reports that as many as 91,000 Americans die each year because they don’t receive the right evidence-based care for such chronic conditions as high blood pressure, diabetes and heart disease.

Quality improvement efforts can help clinicians improve care delivery and practice efficiency. The Robert Wood Johnson Foundation’s Aligning Forces for Quality (AF4Q) initiative is helping doctors, nurses, and other medical professionals systemically improve the quality of care they deliver. The push for quality improvement in clinics, doctors’ offices, and other outpatient (ambulatory) settings is fueled in part by provisions in the Affordable Care Act to spur adherence to evidence-based medicine and help primary care practices improve.

Coaching for Clinical Change: Not only do successful athletes need coaches, health care providers also need them to help improve the care they deliver. Practice coaches are professionals with deep knowledge of health care and training in quality improvement techniques. More than half of the 16 AF4Q community teams use practice coaches to provide training and assistance to providers in their regions. Working with everyone in the practice—from the physician to the receptionist—coaches help develop a specific quality improvement goal and metrics for each individual practice. Practice coaches in AF4Q communities also help spread the success of quality improvement interventions. This brief describes the coaching practice in Cleveland where practice coaches helped spread a technique to improve pneumonia vaccination rates for patients with diabetes.

AF4Q communities are developing interventions and pilot-testing techniques to improve the way ambulatory care is delivered. AF4Q alliances help providers redesign care systems so that high-quality, efficient, patient-centered care results. 


AF4Q in Action

In communities nationwide, AF4Q alliances are developing interventions and pilot-testing techniques to improve the way ambulatory care is delivered. By deploying practice coaches and emphasizing patient-centered care, alliances are fundamentally changing their local health systems.

Learn more about AF4Q

Hear from RWJF

Susan Mende, Senior Program Officer, talks about what ambulatory care is, the quality challenge it faces, and how RWJF's Aligning Forces for Quality initiative is working with health care providers to improve it.

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