Ambulatory Care

Quality Field Notes features key lessons learned by regional Alliances of clinicians, patients, and payers in Aligning Forces for Quality communities as they work to transform local health care and provide models for national reform. The latest topic in this series focuses on regional collaboratives. Regional collaboratives provide unlikely partners—including purchasers, payers, consumer advocates, clinicians, and others—a neutral setting in which collective goals and actionable strategies can be established. For the past eight years...

Aligning Forces Alliances in Maine, Minnesota, and Oregon were recently featured in Health Affairs for their efforts in developing safety-net accountable care organizations (ACO). ACO-focused initiatives have early signs of success in delivering cost-effective, patient-centered care while advancing patient engagement, thus achieving Medicaid’s Triple Aim. Safety-net ACOs are collaborative entities of...

Nathan Wilson, a self-identified “qualitologist,” said that “nothing will agitate a group of physicians more than introducing patient experience surveys into their practice,” despite the benefits of incorporating the patient voice. When patient experience surveys were initially piloted, the results were positive. But, when the program expanded, Wilson found that physicians experienced the “four stages of grieving:” denial, fear, anger, and acceptance. Wilson’s group used the data, and the physicians with the worst patient satisfaction scores...

Published: 2010
Author: AF4Q NPO
This update from the Ambulatory Quality Network highlights the implementation of PCMH pilot projects across numerous alliances. The document summar...
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Published: Dec 2011
Author: AHRQ
A How-to Guide on Developing and Running a Primary Care Practice Facilitation Program released by AHRQ. To download the complete guide, please visi...
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Published: Mar 2013
Author: Maine, Oregon and Humboldt Alliances
The compendium and table of contents from the Engaging Patients in Improving Ambulatory Care Toolkit.
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Published: Jan 2014
Author: AF4Q National Program Office
The Practice Improvement Capacity Rating Scale is a resource for practice coaches to identify readiness of ambulatory practices to conduct quality ...
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Published: Oct 2006
Author: Puget Sound Health Alliance
Gordon Mosser, MD, former president of Minnesota's Institute for Clinical Systems Improvement, presentation on the ICSI model for quality impro...
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Ambulatory Care 101

Improving the quality of ambulatory care has been an area of focus for Aligning Forces for Quality since its inception. Ambulatory care is medical care provided on an outpatient basis—therefore, not requiring a person to be admitted to the hospital. It is provided in physicians' offices, clinics, emergency departments, outpatient surgery centers and hospital settings that do not involve a patient staying overnight. By working with a variety of models such as patient-centered medical homes, practice coaching, learning collaboratives and accountable care organizations, the AF4Q Alliances are developing the essential components to create an infrastructure that supports sustainable improvements in ambulatory quality.