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| The Vermont Health Care Quality Report 2008 |
Ch2: Measuring Quality of Care Ch3: Chronic Illness in Vermont
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Executive Summary and Recommendations (click for printable PDF) The Vermont Program for Quality in Health Care, Inc (VPQ) is an independent, not-for-profit organization whose mission is to develop and implement a system of quality design and measurement for physicians and other healthcare professionals, hospitals and other healthcare facilities, users, and purchasers that produces continuous improvement of healthcare and efficient use of resources. VPQ was incorporated in 1989, is recognized in the Vermont statutes as a peer review organization, and is supported principally by Vermont hospitals, insurers and Dartmouth Hitchcock Medical Center. One of VPQ’s strategic goals is to produce evaluative analyses to illustrate the quality of healthcare in Vermont. These analyses are intended to both guide improvements in patient safety and healthcare quality, and guide policy changes in Vermont’s healthcare system. VPQ hopes that The Vermont Healthcare Quality Report will provide meaningful and Vermont-specific information that will inform the public about the healthcare they receive and drive quality improvement throughout the healthcare system. The Quality Report has evolved over time in an effort to remain relevant. The 2008 Report has been designed principally for use via the web. The preponderance of its content reflects the application of nationally recognized quality measures. The report also highlights emerging issues, reflecting current interest for policy makers, consumers, and healthcare professionals, such as drug resistant infections and end-of-life care in Vermont. Highlighted are some areas which require additional analysis; the opportunity for focused quality improvement; as well as the areas in which the quality of care in Vermont is excellent. We welcome your feedback about this report and our activities. VPQ is dedicated to continually improving the manner in which we report and inform our readers about the quality of care and caregivers in Vermont. Recommendations and Next Steps Reflective of the opportunities for improvement highlighted in the 2008 Report, VPQ will be active in three areas during the coming year: 1) Pursuing new and expanded data sets to support more in-depth and broader scope analyses; 2) Continuing to build a quality improvement infrastructure for those practitioners and organizations working to improve their current method of delivering care; and 3) Disseminating the findings in this report to those private and public organizations accountable for further analysis and potential improvements. 1) New and Expanded Data Sets Over the next year or two, VPQ will obtain the Medicare claims for beneficiaries dually eligible for Medicaid and Medicare. These claims will allow in-depth analyses to better understand the utilization patterns for this resource-intensive population. Additionally, VPQ will gain access to the Vermont Healthcare Claims Uniform Reporting System. This rich data set will allow for in-depth analysis across a broad population base.
2) Building a
State-Wide Quality Improvement Infrastructure VPQ is currently working with partners from around the state to address the quality challenges that face rural healthcare professionals in Vermont. Two Collaboratives, running simultan-eously, are scheduled for the upcoming year, one focused on end-of-life care, and one focused on systems change within the outpatient setting. We believe these activities support the third prong from the IOM’s strategy for improving rural healthcare. VPQ began work on the Vermont Collaborative on End-of-Life Care with a kick-off Learning Session on May 23, 2008. The Collaborative, based on the Institute for Healthcare Improvement model, is a gathering of teams of healthcare professionals and community members committing to a 9-12 month period of rapid change to improve healthcare in their communities. Each team will test a series of small-scale changes in consultation with other teams and experts from around the state, focusing on: pain and symptom management, advance care planning, family and meaningfulness, and continuity of care. VPQ has seen this methodology succeed in the Chronic Care arena, and IHI has used this model for improving end of life care at the national level. The results of the Institute for Healthcare Improvement (IHI) Breakthrough Series Collaborative on Improving End-of-Life Care are outlined in “Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians”. The second Collaborative, the Vermont Quality Improvement Collaborative, will be based on the Care Model (originally the Chronic Care Model) and will use the Model for Improvement and Clinical Microsystems Methodology to guide teams toward systems change. The focus of the Collaborative will be on helping to create an empowered, engaged, educated patient. This model will allow for networking across the state along with giving engaged outpatient provider teams who are not part of Blueprint Communities an opportunity to participate. Participants will include provider teams from the Blueprint Communities, along with provider teams who are working with Vermont Information Technology Leaders (VITL) to implement Electronic Medical Records; teams that are members of the Vermont Rural Health Alliance (VRHA); and provider teams that are outside of all of these venues but who are enthusiastic about improving their patient outcomes (we are calling this group, VPQ friends). 3) Communication with Accountable Organizations on Improvement Opportunities There is a tremendous amount of information in this year’s Report, but it is not necessarily presented so an individual or organization can readily aggregate all the information that pertains just to them. VPQ will advertise its willingness to make specific presentations to those communities, organizations and others that are interested in all the aggregated information that pertains to their sphere of interest and influence. The potential audience might include hospitals, community groups, state government and other groups interested in the face of healthcare in the state and improvement opportunities. |
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