Fostering Quality Improvement Capacity in a Network of Primary Care Practices Affiliated With a Pediatric Accountable Care Organization

Charitha Gowda; Christina Toth; Suzanne Hoholik; Richard J Brilli; Sean Gleeson; Stephen Cardamone

doi:10.1097/pq9.0000000000000175

Fostering Quality Improvement Capacity in a Network of Primary Care Practices Affiliated With a Pediatric Accountable Care Organization

Pediatr Qual Saf. 2019 May 16;4(3):e175. doi: 10.1097/pq9.0000000000000175. eCollection 2019 May-Jun.

Authors

Charitha Gowda^{1

2

3}, Christina Toth², Suzanne Hoholik⁴, Richard J Brilli^{2

5}, Sean Gleeson^{1

2

6}, Stephen Cardamone^{1

2}

Affiliations

¹ Partners For Kids, Columbus, Ohio.
² Nationwide Children's Hospital, Columbus, Ohio.
³ Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, Ohio.
⁴ Department of Quality and Patient Safety, The Ohio State University Wexner Medical Center, Columbus, Ohio.
⁵ Division of Pediatric Critical Care Medicine, Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, Ohio.
⁶ Division of Ambulatory Medicine, The Ohio State University College of Medicine, Columbus, Ohio.

Abstract

Objectives: Quality improvement (QI) methodologies are not widely implemented in primary care practices. As an accountable care organization serving pediatric Medicaid recipients in Ohio, Partners For Kids (PFK) sought to build QI capacity in affiliated primary care practices to improve organizational performance on key quality measures.

Methods: A team of QI specialists developed a comprehensive training program focused on pediatric QI initiatives. From 2014 to 2017, community-based, primary care practices affiliated with PFK were recruited to participate in QI. The primary outcome, assessed yearly, was the proportion of eligible PFK patients accessing care at a practice with ≥1 active QI project. The proportion of QI projects that demonstrated moderate improvement, defined as the implementation of ≥1 intervention and observed improvement in process measures, within 12 months of initiation was also calculated for 2017.

Results: Over the study period, the PFK QI team supported 72 projects in 33 primary care practices throughout central and southeast Ohio. In 2017, 26 practices were engaged in ≥1 active QI project, reaching 26% of all eligible PFK patients. Of the 21 projects active as of January 2017, 11 (52%) showed moderate improvement within 12 months.

Conclusions: The PFK QI team successfully supported QI capacity building in primary care practices throughout Ohio using a systematic approach to recruitment, training, and QI resource support. New, multilevel interventions are needed to promote the uptake of preventive services among patients.