Green Light on Quality Improvement

07 May 2014
The Wisconsin Collaborative for Healthcare Quality (WCHQ) has found its strength in quality measurement and public reporting with a natural evolution that has ushered in a complementary focus on improvement. These mechanisms, hand in hand, have led to advancing its mission to increase health care value and improve the health of people in Wisconsin. Essential to these accomplishments are WCHQ members and stakeholders, including health systems, medical groups, hospitals, purchasers, and consumers.
WCHQ has spurred quality improvement by bringing together workgroups to enhance health care quality and achieve goals established with Aligning Forces for Quality. “We look to the health care organizations to provide the expertise, and we facilitate a peer-to-peer relationship,” said Cindy Schlough, director of strategic partnerships for WCHQ. For example, WCHQ has already achieved the goal of 50 percent of primary care providers demonstrating improvement in five quality measures or associated composite measures within a two-year time frame, including measures of: diabetes all-or-none outcome, diabetes blood pressure control, diabetes all-or-none process, diabetes kidney monitoring, and colorectal cancer screening.
WCHQ has experienced tremendous growth, especially within the past 18 months. More than 60 percent of physicians in the state are submitting data to WCHQ. The number of health care organizations has increased to 38.
WCHQ members and stakeholders gather for bimonthly meetings to share best practices, and this open dialogue has been a lynchpin of its success. WCHQ created a circle of reinforcement; health care organizations are both accountable and available to one another.
“We are competing health systems, and we’re all concerned about market share. But, the focus here is on collaboration and improvement. We don’t use our data against each other. We work to improve our communities. There is integrity in this process,” said Mark Thompson, MD, WCHQ board chair and chief medical officer at Monroe Clinic.
“We’ve worked to have this steady purpose. It’s easy to get distracted by new trends, but that constant attention to improving shared priorities such as diabetes has really made a difference,” said Schlough.
To clearly illustrate areas for improvement for health care organizations, WCHQ creates “scorecards” that put an organization’s publicly reported data in context with red, yellow, and green “stoplight” markers for each measure. This helped challenge some of the assumptions inherent in each organization. There were many ways for health care organizations to improve, but putting the measures on a visual scorecard helped set the agenda and priorities.
WCHQ has also leveled the playing field when it comes to accessing the publicly reported data. WCHQ creates measures summary reports to show the most current results on all of the measures for each organization. Anyone, not just health care organizations with sophisticated data analysts, can download clear and simple spreadsheets. For the health care organizations, the measures summary reports highlight data variations and further encourage better performance.
Looking to the future, WCHQ is responding to the landscape and building on its core strengths. “We’re positioning ourselves to keep a focus on measurement and improvement, but also exploring how to link in payment reforms. Payment needs to be hardwired in,” said Schlough.
WCHQ has partnered since 2010 with the Partnership for Healthcare Payment Reform to support the voluntary engagement of health care stakeholders to implement innovative payment reform strategies. Dr. Thompson forecasts more and more efficiency metrics in which overall quality and costs are evaluated. “There’s certainly a market desire to have transparency around cost and tying quality to cost data,” he said. WCHQ will play an important role in linking measurement and improvement activities with financial incentives.