Regional Health Quality Improvement Coalitions: Lessons across the Life Cycle

Regional Health Quality Improvement Coalitions: Lessons across the Life Cycle

Regional Health Quality Improvement Coalitions: Lessons across the Life Cycle

Regional Health Quality Improvement Coalitions: Lessons across the Life Cycle

Excerpt

In recent years, regional initiatives have been organized to promote and coordinate improvement across various levels and types of health care organizations in a geographic area. We have little information about the factors that facilitate or hinder the development of effective regional coalitions, nor do we understand which strategies at a regional level are most likely to induce significant and lasting improvements in the health and safety of patients.

With interest in learning more about the dynamics involved in the performance of regional health quality improvement coalitions, the Robert Wood Johnson Foundation funded a planning grant for RAND to undertake a pilot study of four such coalitions. These were the Cleveland Health Quality Choice Program, Minnesota's Institute for Clinical Systems Improvement, the Rochester Health Commission, and the Pittsburgh Regional Healthcare Initiative. Using case study methods and a systems approach, the RAND project team collected information on the four coalitions, seeking to identify common issues and factors involved in a coalition's ability to become selfsustaining and to achieve measurable health care improvements in its region. The effective date for the information gathered is spring 2002, which is when the case studies were performed.

This report presents the results of this study, including descriptions of each coalition, summaries of their histories and experiences during formation, and identification of issues arising during subsequent operation. For the coalitions that still remain in operation, we provide brief updates on activities since spring 2002. The report also includes a summary of the key factors for success that were observed across the coalitions, the presentation of a conceptual model built from a combination of our case study findings and a review of systems models, and a related set of observations and testable hypotheses regarding factors that may contribute to the successful performance of regional health quality improvement coalitions.

This report will be of interest to policymakers and researchers working with system approaches for achieving improvements in our health care system. The study findings also should be useful for individuals and organizations embarking upon similar regional health quality improvement coalitions in other regions.

The work presented in this report was performed under Agreement Number 040729 for the Robert Wood Johnson Foundation, Princeton, New Jersey, with Laura Leviton as Project Officer.

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