The Anatomy of Collaborative
Improvement
Greta L. Krapohl PhD, RN
Lieutenant Colonel, U.S. Army
(Retired)
Acknowledgment: The MSQC Team
Agenda
Agenda
•Introduction
•Dissection of the MSQC ‘Quality Space’
–Strong Data
–Safe Data
–Travel the blue highways
–Be deviant (positively)
–Innovate
–Measure outcomes and improvement
–Trust
–Focus
–Kick the tires
•Putting it all back together
•Conclusion Q&A
Strong Data
Examples
•Definitions
–Specimen weight
–Postoperative normothermia
Examples
•Failure to Rescue
Examples
•Inter-rater Reliability- measurement to assess
the degree to which different people agree in
their assessment decisions.
•Validity- measuring what we are supposed to
be measuring
Accuracy of Smartphone Applications and Wearable Devices for
Tracking Physical Activity Data
Meredith A. Case, BA1; Holland A. Burwick2; Kevin G. Volpp, MD, PhD3;
Mitesh S. Patel, MD, MBA, MS3
JAMA. 2015;313(6):625-626. doi:10.1001/jama.2014.17841.
Reduce hospital payment by 1% for hospitals that
rank among lowest performing 25%
Discharges starting October 1, 2014:
Safe Data
New Patient Safety Organizations Can Help Health Providers Learn From and Reduce
Patient Safety Events. Clancy, Carolyn M. MD Journal of Patient Safety: 5(1): 1-2. 2009 June.
Travel the Blue Highways
Practice-Based Research—“Blue Highways” on the NIH Roadmap
John M. Westfall, MD, MPH; James Mold, MD, MPH; Lyle Fagnan, MD
JAMA. 297(4):403-6, 2007 Jan 24.
NIH roadmap could benefit from “blue highway” or practice-
based research that connects major academic centers to rural
areas.
Be Deviant (Positively)
14
MSQC follows the principles of “positive deviance” as an
approach to identify practices that improve healthcare quality.
Research in action: Using positive deviance to improve quality of health care
Elizabeth H Bradley, Leslie A Curry, Shoba Ramanadhan, Laura Rowe, Ingrid M Nembhard
and Harlan M Krumholz
Implementation Science. 4(25):1-11, 2009
Innovate
Big Med. Atul Gawande , The New Yorker, August 13, 2012
Speaks to the need for innovation in healthcare and breaking the dogma in
medicine.
Measure Performance and Improvement
Focus
Kick the tires
Osborne NH, Nicholas LH, Ryan AM, Thumma JR, Dimick JB
Association of Hospital Participation in a Quality Reporting Program With Surgical
Outcomes and Expenditures for Medicare Beneficiaries
JAMA 2015;313(5):496-504
Summary
Dissection of the MSQC ‘Quality Space’
–Strong Data
–Safe Data
–Travel the blue highways
–Be deviant (positively)
–Innovate
–Measure outcomes and improvement
–Trust
–Focus
–Kick the tires
Conclusion
I have always thought of our collaborative as an
organization that will “help you do what you do
better.”
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Questions?
Questions?
