Quality of Care: Guidance for Addressing Health Care Systems Change

Belinda Minta, MPH, Public Health Educator, CDC (moderator)
Amy Carte, RNC, MS, Cardiovascular Health Program Manager, West Virginia Bureau for Public Health
Debbie Ruppert, RN, Director, Performance Improvement, West Virginia Hospital Association,
West Virginia Coalition for Quality Healthcare

Objective/Supporting Skills and Knowledge

Upon completion of this workshop, participants will be able to:

Discuss partnerships with entities such as hospitals and primary care providers that may yield significant changes within and across healthcare systems
Utilize a case study method to explore and assess the planning, decisions, and strategies utilized by a state program and the hospital association to promote adherence to evidence-based guidelines and recommendations
Review inventory of health systems-based quality improvement programs/projects/initiatives
Assess and determine the applicability of the CVH Health Care Systems Guide

Summary

What is quality? Quality has been defined as anything that exceeds established expectations. The provision of appropriate care to the right population at the right time translates into quality health care. Unfortunately, the existing health care system paints a different picture.

The Institute of Medicine points to the increase in chronic conditions, poorly organized delivery systems and constraints on exploiting the revolution in information technology as some of the underlying factors that have contributed to the inadequate quality of healthcare. (Crossing the Quality Chasm, 2001) According to the Advisory Commission on Consumer Protection and Quality in the Health Care Industry (1998), all health care organizations, professional groups, and private and public purchasers should:

Adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States
Pursue six major aims; specifically, health care should be safe, effective, patient-centered, timely, efficient, and equitable

As public health entities, State Heart Disease and Stroke Prevention programs (HDSPP) play a significant role in assisting health care systems fulfill these recommendations and improving the delivery and quality of care. Through partnerships, HDSPPs have developed, implemented, and evaluated activities to effect changes in the healthcare system.

This interactive session will address potential partnerships and challenges to consider when planning health systems change activities, dissect a hypothetical health systems problem from “soup-to-nuts”, and explore coordinated and multidisciplinary approaches. In addition to handouts and other resources that will be disseminated, we will utilize personal knowledge, skills, real-life experiences to strategize on ways to impact health care systems. Additionally, a State HDSPP will share its experience in implementing a hospital-based heart disease management intervention. Lastly, we will evaluate the CDC/CVH draft health systems guide and its usability and applicability to our current practices.