Case Studies: Leveraging Performance Measurement for Quality Improvement

These case studies examine how three Aligning Forces for Quality communities used physician performance measurement data in quality improvement initiatives.

In Cincinnati, a Health Collaborative-led Physician Leadership Group focused on a set of five treatment goals, known as the D5, that together represent the gold standard for managing diabetes. Participating physicians voluntarily provided patient data and received a report with their practice's D5 scores, as well as a community-wide score to serve as a benchmark. Over the past three years, the report has grown to include 600 participating doctors, and between 2010 and 2012 the average rate of patients in a practice that achieved target goals on all five measures improved from 28 to 30 percent.

After examining its public reports and learning that colorectal screening rates in some practices in Wisconsin were under 50 percent, the Wisconsin Collaborative for Healthcare Quality (WCHQ) launched the Colorectal Cancer Screening Project. Over a six month period, a member-led project team reviewed barriers and gaps to getting recommended screenings and identified a set of best practices clinics can use to increase screening rates. In 2012, WCHQ practices screened nearly 75 percent of patients for colorectal cancer, an increase from a community average of 68 percent in 2009.

Better Health Greater Cleveland analyzed data from its public reports to identify top-performing clinics so it could spread best practices. Better Health's Data Center noticed that among the 35 participating practices, the top nine performers for pneumonia vaccination rates—a critical piece of quality diabetes care—were part of the MetroHealth System. MetroHealth shared its protocols so other practices could replicate them, and in just three years the vaccination rates of practices in other health systems climbed from 70 to 82 percent.