Feb 4 2013
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You’re Invited to a Virtual Meeting on Advancing the Science of Quality Improvement Research and Evaluation

Lori Melichar, PhD, is a director at the Robert Wood Johnson Foundation (RWJF). 

Lori Melichar

The Robert Wood Johnson Foundation’s mission is to improve the health and health care of all Americans. In pursuit of this mission, we seek to improve the quality of care provided in hospitals, ambulatory care centers, public health departments, and other settings where health is enhanced or health care is delivered.

Within the past 15 years, Quality Improvement (QI)—the process-based data-driven approach to improving the quality of a product or service through iterative action-evaluation cycles—has emerged as a promising strategy to accomplish this goal, and RWJF funded several national programs to “demonstrate” the potential of QI to improve health care processes, staff engagement and patient outcomes.  The Foundation’s Pursuing Perfection Program, which had as its goal to help hospital and physician organizations improve patient outcomes dramatically by pursuing perfection in major care processes, employed QI tools such as Plan-Do-Study-Act cycles and improvement collaboratives to accomplish this goal.  Another program, Transforming Care at the Bedside, taught frontline nurses the skills and methods of QI and empowered these staff to engage in activities to transform hospital care.  Paths to Recovery is an RWJF program that used QI processes to improve the systems of care that provided substance abuse treatment. Aligning Forces for Quality  is RWJF’s signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities, and provide models for national reform.

From 2007 through 2011, researchers at the Boston University School of Management Health Policy Institute supported efforts by the RWJF Human Capital Team to increase the number of health care workers who are highly proficient in quality improvement methods and tools. To achieve this, researchers surveyed the field of quality improvement training to ascertain its present scope and availability, as well as to determine factors hindering or encouraging the use of training. 

One outcome of this evaluation was a resource guide that summarized programmatic options in quality improvement training

Another was a Call for Proposals issued by RWJF to evaluate quality improvement training programs. This program, Evidence for Improvement: Evaluating Quality Improvement Training Program, aimed to increase the understanding of what works in quality improvement training programs to increase the likelihood that more organizations will adopt best practices and more health providers will acquire quality improvement training.

In 2008, RWJF launched this $2 million dollar initiative by awarding grants to evaluate five different quality improvement programs. 

These grants, summarized below, are completed and results will be presented in a free virtual meeting on February 13.  To participate, please email Anita Roberts (aroberts@rwjf.org) and put “ASQUIRE meeting” in the subject line of your email.

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The five quality improvement programs that received grants for evaluation are:

Evaluation of the Perfecting Patient Care University: RAND Corporation

The subject of this evaluation was the Perfecting Patient Care University (PPC) operated by the Pittsburgh Regional Health Initiative, which is a nonprofit operating arm of the Jewish Healthcare Foundation. This evaluation was designed to examine the effects of the PPC training on the subsequent quality improvement activities of the organizations that have sent staff for PPC training.

Evaluation of a Two-Pronged Training Program to Build Capacity for Quality:  Emory University Rollin’s School of Public Health

This project addressed whether QI training programs result in meaningful clinical and organizational benefits by evaluating two training programs developed by Emory Healthcare: The Leadership for Healthcare Improvement Program and the Practical Methods for Healthcare Improvement Program.

Evaluation of Quality Improvement Training/Capacity Building: The AED Center on AIDS and Community Health

The purpose of this study was to evaluate the QI training conducted by the National Quality Center, an initiative funded by the Health Resources and Services Administration to advance the quality of care of individuals living with HIV/AIDS. 

To Achieve the Best: Evaluating Quality Improvement Training as a Means to an End:  Cincinnati Children’s Hospital Medical Center (CCHMC)   

This study focused on CCHMC’s Intermediate Improvement Science Series (I2S 2) and Advanced Improvement Methods. Project Goals included studying participant satisfaction, the learning that took place as a result of training and participants’ ability to apply what they had learned after training completion.  Contextual factors that facilitated or impeded these factors were also assessed.

Evaluating the Effectiveness of NACCHO Quality Improvement Training Initiatives:  The University of North Carolina Gillings School of Global Public Health

The goals for this project included: 1) creating a research collaborative with North Carolina Institute for Public Health staff, faculty experts from the University of Southern Maine and University of Minnesota, and staff from the National Association of County and City Health Officials (NACCHO); 2) conducting an evaluation survey to examine the effectiveness of NACCHO quality improvement trainings: and 3) examining through qualitative methods how and under what circumstances local health departments create a quality improvement culture.

These evaluation projects were coupled with a separate $1.5 million dollar investment for Improving the Science of Continuous Quality Improvement Programs and Evaluations.

Both of the research teams are members of an RWJF ASQUIRE (Advancing the Science of QI Research and Evaluation) community.  The grantees have been convened periodically in person and virtually so that we might closely monitor their progress and highlight opportunities for collaboration and cooperation across teams. 

We hope that this work, combined with future RWJF investments in this area, will have an important impact on the field of QI research and evaluation, but that is not the end purpose of this work. The projects were funded by RWJF with high hopes that they would have an impact on health and health care of Americans. 

Please forward a link to this blog post to those who might benefit from new tools to evaluate their QI work.

Tags: Health Care Quality, RWJF Leaders, Research & Analysis