Quality Committee Update

As we continue to work as an Alliance towards achieving the Institute of Healthcare Improvement’s Triple Aim goals of improved patient experiences and population health while lowering cost, the Quality Committee has determined to shift our paradigm from a focus on metric performance and reporting to global management of specific disease processes or conditions that impose the greatest burden on our system. Metric performance and reporting is critically important but tends to fall almost exclusively on individual providers, generally at the primary care level. Furthermore, we have developed a very strong team of analysts and a system of data extraction that has made our metric reporting incredibly efficient and centralized. We all owe this team our gratitude for covering our collective quality reporting requirements under the previous PQRS and evolving MACRA environment!

Moving forward, though, our new paradigm focusing on disease processes is intended to harness the true strength of the Mary Washington Health Alliance—cooperation and collaboration among our specialists, who are experts in their chosen fields; primary care providers, who are our patients’ partners and advocates for their care; and a hospital system that has combined a historical commitment with a new progressive impulse to care for our regional community. Our shared objective is to provide the safest, most advanced and effective healthcare possible in a fiscally responsible manner, and by emphasizing a multidisciplinary approach, become a type of “center of excellence” that will attract patients from our region and beyond.

Over the last six months or so, we have launched our new approach with a pilot program aimed at improving our system-wide care for patients with COPD, which is an exceptionally prevalent problem in our community, and are in the midst of developing a more formalized process for managing back pain and addressing the use of opiates in our community. As part of the COPD pilot, our pulmonologists have stepped up wonderfully to engage with more of these patients in the hospital and provide early follow up after discharge. Our navigators on the hospital side along with the Alliance’s RN Care Coordinators, who are really the connective tissue of our organization, have been able to develop more tools by which to remain in contact with our targeted patients both in and out of the hospital and ensure consistent care is being given. We have partnered with the Palliative & Hospice Care team to provide more goals of care discussions and perhaps eventually supplement outpatient care. And, of course, we are asking our primary care providers to help coordinate all these efforts by seeing these patients as soon as possible after hospital discharge.

With regard to back pain treatment and opiate use, we are engaging our neurosurgeons, orthopedic spine surgeons, and physical medicine & rehab specialists to define and aggregate the latest specialty-specific guidelines on management of acute back pain. By defining the appropriate available resources, we hope to expand the capacity of the Alliance to cover these episodes beyond what our primary care providers can do in the regular course of business and mitigate the inappropriate use of the ER. Furthermore, we hope to use this issue as a means of developing models for communicating with both our member providers and our patient population on health related topics and Alliance resources.

Overall, we are very excited about the direction the Alliance is taking towards enhancing patient experiences and improving population health and quality of care. We cannot emphasize enough that in these efforts, our strength is our diversity of training and expertise and we intend to utilize that to the fullest. To that end, I would enthusiastically invite any Alliance member to provide the Quality Committee with any input or ideas you might have regarding specific disease management, collaborative projects, or ways the care coordination team might enhance your patient care. We truly desire a recognition by each member of the Alliance of the value that is added by working together as a multidisciplinary team to create a level of care our community deserves!