QI Strategies | Quality 101 | SHM's Quality & Innovation Initiatives


QI Strategy

Example

Provider reminder systems

  • Reminders in charts for providers
  • Computer-based reminders for providers
  • Computer-based decision support

Facilitated relay of clinical data to providers

  • Transmission of clinical data from outpatient specialty clinic to primary care provider by means other than medical record, e.g., phone call or fax

Audit and feedback

  • Feedback of performance to individual providers
  • Quality indicators and reports
  • National/state quality report cards
  • Publicly released performance data
  • Benchmarking – provision of outcomes data from top performers for comparison with provider’s own data

Provider education

  • Workshops and conferences
  • Educational outreach visits (e.g., academic detailing)
  • Distributed educational material

Patient education

  • Classes
  • Parent and family education
  • Patient pamphlets
  • Intensive education strategies promoting self-management of chronic conditions

Promotion of self-management

  • Materials and devices promoting self-management

Patient reminder systems

  • Postcards or calls to patients

Organizational change

  • Case management, disease management
  • CQI techniques
  • Multidisciplinary teams
  • Change from paper to computer-based records
  • Increased staffing
  • Skill mix changes

Financial incentives, regulation and policy

Provider-Directed:

  • Financial incentives based on achievement of performance goals
  • Alternative reimbursement systems (e.g. fee-for-service, capitated payments)
  • Licensure requirements

Patient-Directed:

  • Co-payments for certain visit types
  • Health insurance premiums, user fees

Health System-Directed:

  • Initiatives by accreditation bodies (e.g., residency work hour limits)
  • Changes in reimbursement schemes (e.g., capitation, prospective payment, salaried providers)
Source: Shojania KG, McDonald KM, Wachter RM, Owens DK. Series Overview and Methodology. 2004.
Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies; vol 1.
Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/qualgap1/qualgap1.pdf.

If you need additional support in leading a quality improvement effort, SHM’s signature programs can guide your team through each phase and provide individual mentoring in areas such as care transitions (Project BOOST®), Glycemic Control (GC), Medication Reconciliation (MARQUIS), Atrial Fibrillation (AFIB) and Venous Thromboembolism (VTE). We also provide resources by clinical topic to help you find exactly what you need.

No matter where you are in the spectrum, SHM can assist you in your efforts. SHM encourages you to join the QI community and view the calendar for up to date information on key events and discussions around the quality and innovation movement.

Questions or Comments, please email thecenter@hospitalmedicine.org.