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mayo 26, 2019

MNHC Quality Improvement Program Expands by Engaging Employees to Help Achieve Outcomes

Improving healthcare outcomes has always been a key value of Mission Neighborhood Health Center (MNHC). For over 20 years, MNHC has had a Clinical Quality Management (QM) Committee whose members included managers, clinical chiefs and directors who set priorities and approve the overall Quality Management plan.

While that structure has proved effective for many years, what was evident to Lauren Wallace, QI Manager, who joined MNHC in 2017, is that it was a top down process. Employees who have a direct effect on outcomes were not participating in the process, fully engaged nor empowered to move the needle.

So Lauren, working closely with Stephanie Furtado, Director of Clinical Operations and Quality Improvement, set about to change that paradigm by enlisting the front line staff to help improve outcomes. In January 2018, a new Quality Improvement (QI) committee was formed that includes membership from each department. Managers were asked to elect a departmental influencer who was interested in change. Along with each departmental champion, managers from each department meet monthly to learn more about QI methodology and how to measure, monitor and improve outcomes and set departmental goals.

Champions and their managers from Excelsior, Shotwell Adult, Shotwell Pediatrics, Women’s Clinic, Teen Clinic, Resource Center, Nutrition, and Patient Services engage in an active process that includes an ongoing extensive training program using real data to teach members to improve tech literacy and learn about such topics as root cause analysis, i2i Population Analytics program, Plan-Do-Study-Acts – used to conduct tests of change; Social Determinants of Health (SDOH), the importance of accurate and consistent documentation, and more.

In addition to the monthly meetings, Lauren meets one-on-one with each department to assist with their individual goals.

“I love coaching teams and individuals,” said Lauren. “It’s very gratifying to see them understand how they have a direct effect on measuring data and movement in outcomes that they can see tangibly through increased funding.”

Together the team selects annual departmental goals that coincide with the SF Health Plan Practice Improvement Program priority metrics and Uniform Data System (UDS) metrics, a standardized reporting system used by federally qualified health centers (FQHC) across the nation.

A common challenge for committee members is scheduling time each week to focus on QI, as they are often busy with clinical work. Understanding this dilemma, Lauren structured the monthly meetings to incorporate work-time for the team members as well as sharing best practices for outcomes that may overlap between departments. The members have found this focused time to be very helpful.

To generate even greater awareness and buy-in among all employees, QI bulletin boards hang in strategic areas and an attractive, easy-to-read monthly QI newsletter is sent to all MNHC employees. The boards and newsletter share departmental initiatives, progress on QI goals as well as training articles. Recent highlights included an update from the nutritionist regarding efforts in diabetes management and QI progress made by Patient Services. Additionally, managers have been asked to include a standing item on all departmental meetings discussing quality improvement goals and progress.

“Ultimately we’d like each employee to be able to be aware of their department’s QI goals and progress,” said Lauren. “We would be very pleased with that outcome.”

Over the next year, the QI teams will continue to work towards their 2019 goals, increasing QI awareness in their departments, and strengthening their QI skills. Lauren plans to share the successes of MNHC’s QI teams at local and national conferences.

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