The Quality Improvement Learning Collaborative (QILC) model has emerged as a powerful approach within the healthcare sector to drive meaningful improvements in patient care and health outcomes. This collaborative framework brings together healthcare professionals from various practices to learn from each other, share best practices, and implement evidence-based strategies to address specific healthcare challenges.
Key Drivers of Quality Improvement in Healthcare Settings
The American Academy of Pediatrics (AAP) has identified several key drivers that are crucial for successful quality improvement initiatives at the practice level. These drivers are particularly relevant when implementing a trauma- and resilience-informed care approach, which recognizes the impact of trauma on health and well-being. Key drivers include:
- Preparing practice environment for trauma- and resilience-informed care: Creating a safe and supportive environment is fundamental for both patients and staff, fostering trust and promoting healing.
- Fostering and continually expanding referral networks: Establishing strong connections with community resources and specialists ensures patients receive comprehensive and coordinated care.
- Utilizing family-centered, strength-based approaches: Engaging families as active partners in care and focusing on their strengths leads to more effective and sustainable interventions.
- Establishing and maintaining effective systems to support assessment, primary care intervention, referral, and follow-up: Well-defined systems streamline processes, ensure timely interventions, and improve continuity of care.
- Ensuring care is delivered to advance racial and ethnic equity: Addressing health disparities and promoting equitable access to high-quality care for all populations is a critical ethical and quality imperative.
These key drivers provide a roadmap for healthcare practices aiming to enhance their services through a quality improvement learning collaborative.
The ASHEW Quality Improvement Learning Collaborative: A Case Study
The AAP funded chapters across seven states to implement the Advancing Social Health and Early Childhood Wellness (ASHEW) quality improvement learning collaborative. This initiative involved 66 primary care practices and aimed to integrate early relational health principles into routine well-child visits.
The primary goal of the ASHEW quality improvement learning collaborative was to achieve 90% implementation of screening, discussion, referral/linkage, and follow-up for perinatal depression, social drivers of health (SDOH), and social-emotional development during well-child checks for children aged 6 months to 5 years.
Result Highlights and Impact
The ASHEW quality improvement learning collaborative demonstrated significant progress in several key areas. Notably, the implementation of SDOH screening showed the most substantial improvement over the project period. Screening for perinatal depression was already high at the beginning and exceeded the target goal by the project’s end. However, screening for social-emotional development started at a lower rate and remained relatively low, indicating a need for further education and training in this specific domain.
While screening rates improved, the collaborative also highlighted the importance of consistent referral and linkage to services following positive screens. Referrals were less consistently implemented than screening, potentially due to external barriers such as resource availability and accessibility.
Stakeholder Feedback: Voices from the Collaborative
The ASHEW quality improvement learning collaborative actively engaged diverse stakeholders, including chapter leadership teams, healthcare providers, healthcare team members, practice QI teams, and family advisors. An evaluation conducted by JBS International, Inc. gathered valuable feedback, revealing several key insights:
- Enhanced Provider Confidence: Nearly all healthcare providers reported feeling more competent in addressing the SDOH-related needs of their patients and families as a result of participating in the quality improvement learning collaborative.
- Chapter Capacity Building: Chapter leadership teams emphasized that prior experience in building strong relationships with practices and teaching QI methodologies were crucial for the success of the ASHEW collaborative.
- Family Advisor Support: Family advisors highlighted the need for clear roles and responsibilities, such as job descriptions, to effectively support their contributions within the collaborative.
- Practice-Level Changes: The most frequently reported practice changes resulting from the quality improvement learning collaborative were the adoption of new screening tools (89%) and the strengthening of existing screening practices (86%).
- Financial Sustainability: Over half of practice QI teams (53%) anticipated using Medicaid payments to sustain activities related to social health and early childhood wellness after the completion of the ASHEW collaborative.
Resources for Quality Improvement Initiatives
The ASHEW quality improvement learning collaborative has generated valuable resources that can support other healthcare organizations in implementing similar initiatives. These resources offer practical guidance and tools for establishing and managing effective quality improvement learning collaboratives focused on enhancing patient care and addressing critical health needs.
In conclusion, the quality improvement learning collaborative model, exemplified by the ASHEW initiative, provides a robust framework for driving positive change in healthcare practices. By focusing on key drivers, fostering collaboration, and utilizing data-driven approaches, healthcare organizations can effectively improve the quality of care they deliver and ultimately enhance patient outcomes.
