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VT Health Care Quality Report
2010 Quality Report

Overview and Recommendations

Creating Useful Information from Data

Interpreting Information to Create Knowledge

Using Knowledge to Design Interventions

Evaluation: Did We Make a Difference?

Comprehensive QI Parternships

Annual Report

____________________________

2009 Quality Report

Executive Summary and Recommendations

Background

Chapter 1: Chronic Illness

Chapter 2: Mental Health and Substance Abuse

Chapter 3: Quality Improvement

Chapter 4: End-of-Life Care

Chapter 5: Rural Health Care

Chapter 6: Measuring Quality

Chapter 7: VT Findings from National Reports

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VPQ Background

History
The Vermont Program for Quality in Health Care, Inc (VPQ) was created in 1988 by a coalition of health care providers, payers, employers and consumers as an independent, non-profit corporation.  In 1989, the Vermont legislature recognized VPQ’s role in improving healthcare quality and Vermont’s Peer Review Committee statute was amended to specifically designate the Vermont Program for Quality and Health Care as an independent, non-regulatory, peer review committee.
 
Mission
We improve health care quality in Vermont by studying the system and making it work better.

  • We serve as a reliable source for data collection and analysis on healthcare quality
  • We establish appropriate and effective standards and measurement tools for quality of care
  • We educate healthcare providers on quality improvement
  • We inform consumers and make recommendations to policymakers on issues of healthcare quality
Strategic Goals
Based on our mission, four strategic goals guide the work undertaken by VPQ.  These strategic goals are:

1.       Produce evaluative analyses to illustrate the quality of healthcare in Vermont.  These analyses are intended to both guide sharp-edged improvements in patient safety and healthcare quality, and guide policy changes in Vermont’s healthcare system. 
2.       Support quality improvement and clinical best practices at the Clinical Microsystems level where care is actually delivered.
3.       Serve as the state’s premier organization dedicated to quality improvement in health care and to providing expert information and advice to the diverse constituencies it serves.
4.       Ensure adequate financial resources and staffing capacity to maintain a high level of excellence, to achieve its external goals, and to respond to unique opportunities and identified needs as they arise.   
 
Financial Support
Financial support for VPQ’s work comes from a number of sources.  As required by state law, the Department of Banking, Insurance, Securities and Health Care Administration (BISHCA) contracts annually with VPQ to “implement and maintain a statewide quality assurance system to evaluate and improve the quality of health care services rendered by health care providers or health care facilities including managed care organizations...” (18 V.S.A. §9414).  The Department, in turn, charges the cost of that contract to Vermont hospitals and to HMOs and health insurers doing business in the state.  Dartmouth-Hitchcock Medical Center and Retreat Healthcare, while not subject to this law, make voluntary contributions to VPQ’s operations. 

VPQ’s budget for fiscal year 2009 included $ 1,766,775 in income, with 42% funded by the 9416 billback through BISHCA.  A significant portion of new FY 2009 income ($237,000) was attributable to a pass through for the purchase and support of DocSite, a registry selected by the Vermont Department of Health for their Medical Home Blueprint Pilot Communities.  In FY2010, income is projected to decrease to $1,269,053.  The projected figure will no longer include the DocSite work and for the first time billback funds have been redirected by BISHCA to another entity.  With the legislature’s support, BISHCA will use $100,000 of the traditional VPQ core funding to engage The Dartmouth Institute.  The reduced 9416 core funding supports general program operations and activities such as publication of the Vermont Health Care Quality Report, many of the quality improvement projects and analyses, and direct support to BISHCA in their Community Hospital Reporting efforts.  Additional revenue comes from other grants and contracts.  VPQ works with the Office of Vermont Health Access, the Vermont Department of Health, the Vermont Agency of Human Services, the Department of Disabilities, Aging and Independent Living, and the Health Care Administration, along with hospitals and practitioners from around Vermont.  


INCOME

 
FY 2009

(Reviewed)

FY2010

(Projected)

 
9416 Billback

9416 Carry Forward

$749,617

$660,000

$12,108

 
Other Contracts and Contributions

$1,017,158

$596,945

 
TOTAL

$1,766,775

$1,269,053

 
 
 

 

EXPENSES

 
 

 

 
Personnel

$786,794

$803,361

 
Operating

$122,300

$118,951

 
Project

$831,367

$344,132

 
TOTAL

Net Operating Income

$1,740,461

($50,386)

$1,266,444

($2,609)

 
 
VPQ Staff

Helen Riehle, Executive Director, is responsible for overall management of the organization.  This includes financial management, planning, external relations, and support for the board of directors.  While much of her time is spent on administrative matters, she attends most of our clinical study groups and provides guidance to all of our projects.  Helen has been employed by VPQ since September 2000. Prior to joining VPQ, she served in the Vermont Legislature for 18 years.  She received a BS in Education from the University of Vermont.
 
W. Cyrus Jordan, MD, MPH, Medical Director, is trained and board certified in pediatrics and family medicine.  He earned an undergraduate degree in mathematics from Dartmouth College, his medical degree from the University of Connecticut, and a master’s degree from the Harvard School of Public Health.  Prior to joining VPQ, Dr. Jordan practiced pediatric and family medicine in VT for 10 years.  Cy is involved in nearly all of our projects, providing clinical and analytic expertise and serves as an important primary liaison with physicians throughout Vermont and the Dartmouth Hitchcock physician community.  He has worked at VPQ since 1992.
 
Timothy Stickle, PhD, Acting Director of Evaluative Sciences, received a Ph.D. in Clinical Psychology from the University of Arizona with a second concentration in Program Evaluation & Research Methodology.  He completed his Clinical Psychology Residency at University of Washington School of Medicine.  Tim joined VPQ part-time in 2008 and enhances VPQ’s analytic team.  In addition to evaluation work with VPQ, Dr. Stickle is Associate Professor of Psychology, Acting Director of Clinical Training, Director of Biostatistics for the Anxiety and Health Research Laboratory, and Director, Developmental Psychopathology Laboratory at University of Vermont.  Dr Stickle conducts research in the areas of adult and pediatric mental health, juvenile justice, health, health care, and research methodology. Tim has worked as an evaluator, clinician, and administrator for a variety of organizations including: Health Services Advisory Group; the United Nations Food and Agriculture Organization; Arizona Governor’s office; Seattle Children’s Home; Comprehensive Mental Health Center; and Louisiana Office of Mental Health.
 
Patricia Launer, BA, RN, CPHQ, Quality Improvement Advisor, works on numerous projects providing technical assistance, quality improvement coaching and support for external quality improvement efforts with Vermont hospitals, providers and communities.  She earned a degree in Nursing from Castleton State College, and an undergraduate degree in Anthropology from the University of Vermont.  Patty has ten years of nursing experience in acute care facilities centered on pediatric nursing and has worked at VPQ since 2000.
 
Monica Boyd, MS, Research Analyst, was the lead in producing the 2009 Quality Report, VPQ analytic efforts, and provides technical assistance.  Monica joined the VPQ staff in 2005 as the first Research Analyst.  Prior to joining VPQ, she worked in state government in the Department of Developmental and Mental Health Services as a senior research and statistics analyst as well as the Department of Aging and Independent Living.  Monica earned an undergraduate degree from Grand Valley State University in statistics and a master’s degree from the University of Vermont in biostatistics.
 
Lea Fournier, Business Manager, has provided financial management of the organization and human resource assistance to the staff since 1989.  Lea has previously worked for the Arizona Health Sciences Center and the VT Dept. of Health. 
 
Bill Marcinkowski, Information Systems Manager, has been working for VPQ since 2001 serving as network and PC support for staff and is involved with several projects, including the Quality Report.  Bill attended the University of New Hampshire where he received a Bachelor of Arts degree majoring in Communications.  His first career was in the broadcast television field where he worked for New Hampshire Public Television in a technical capacity.  His career shifted slightly with a position constructing control rooms and classrooms for instructional television.  He worked as a site manager for the College for Life Long Learning now Granite State College.  He was on-site support for the college computer lab as well as supporting faculty and staff and students in Lebanon.   He also worked briefly for Norwich University as Help desk coordinator before coming to VPQ.
 
Dail Riley, Project Coordinator/Office Manager, provides administrative support and coordination for all of our projects, serves as point person for many of our Collaborative and Learning Forum activities, and maintains the VPQ contact database and office management.  Dail previously worked at the Vermont Land Trust for thirteen years, joining VPQ in July 2001.

Linda Schlott, Administrative Assistant, is responsible for planning and scheduling of Board of Directors’ and committee meetings, provides administrative support to the staff as well as final editing for all our publications.  She holds a B.A. in Spanish from SUNY Stony Brook.  Prior to joining VPQ, Linda worked at McGraw-Hill, the Vermont League of Cities and Towns and most recently at Community College of Vermont.  She joined the VPQ staff in 2002.
 
Margaret Caudill-Slosberg, MD, PhD, MPH, Rural Hospital Quality Improvement Specialist, is a board-certified internist and a Diplomate of Pain Medicine.  She was a Quality Scholar at the White River Junction VA from 2003-2005. Dr. Caudill-Slosberg joined VPQ part-time in 2007.  She provides support and assistance to Critical Access Hospitals in developing a quality network and performing the required annual reviews for CMS conditions of participation.   She is currently Instructor of Anesthesiology, at Dartmouth Hitchcock Medical Center, Pain Management Center, Lebanon, NH and Adjunct Associate Professor of Clinical and Family Medicine, Dartmouth College, Hanover, NH.  She also teaches in the Dartmouth Institute’s MPH program.

Victoria McLaughlin, BS, Center for Evaluation Intern, is currently an intern at VPQ.  Vicki provided an integral role to the 2009 Quality Report.  She received a B.S. in mechanical engineering from Cornell University and is currently working toward a master’s in Statistics from the University of Vermont.  Before graduate school, she spent 9 years in the aerospace industry, most recently as Director of Manufacturing at Goodrich Aircraft and Integrated Systems in Vergennes, VT.    
 
Cuar an Chlair

 

 
VPQ BOARD OF DIRECTORS – 2009
 
Chair – Connie Colman
Vice Chair – Peter Albert
Treasurer – Stephen Perkins, MD
Secretary – Dan Johnson

 
Peter Albert, LICSW
Director PrimariLink & External Affairs, Retreat Healthcare
 
Gerhild Bjornson, PhD, MD
CIGNA
 
Hunt Blair
VT Deputy Director of Health Care Reform

Patricia Burnham, PhD
Consumer Representative
 
Harry L. Chen, MD
former Vermont State Representative

Connie Colman, RN, M.Ed
Quality Improvement Director, Central VT Home Health & Hospice

James Daily
President, Porter Medical Center

Cecile Furlong, RN
Nurse Case Manager, Good Neighbor Health Clinic, Consumer Representative

 Paul Harrington
Executive Vice President, VT Medical Society
 
Dan Johnson
Senior Vice President, Hickok & Boardman; VT Business Roundtable
 
John M. Lindley III
CEO, John M. Lindley Insurance Agency, Inc.; Public Oversight Commission
 
Lisabeth Maloney, MD, MS
Dartmouth-Hitchcock Medical Center
 
Rilla Murray, PhD
NASW-Vermont Chapter, Executive Director
 
Anna Noonan
VP, Quality Care Management, Fletcher Allen Health Care
 
Christine Oliver
Deputy Commissioner, Health Care Administration
 
Jill Olson
Vice President of Policy & Operations, VT Association of Hospitals & Health Systems
 
Stephen Perkins, MD
Medical Director, Blue Cross Blue Shield of Vermont
 
Thomas A. Simpatico, MD
Professor of Psychiatry, University of Vermont
 
Shawn Skaflestad
Quality Improvement Manager, Agency of Human Services
 
Donald Swartz, MD
Medical Director, VT Department of Health
 
Stuart Williams, MD
Berlin Family Health (FAHC)


Vermont Program for Quality in Health Care, Inc.
132 Main Street, P.O. Box 1356, Montpelier, VT 05601
Phone: 802.229.2152 | Fax: 802.229.5098
Email:
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