Enhancing Care Through Quality Improvement

By: Eminet Gurganus, MPH

Connecticut Children’s Medical Center is committed to assisting primary care and subspecialty providers improve the services they provide to children through a data-driven, quality improvement approach.

Our Practice Quality Improvement (PQI) program, which is part of the Connecticut Children’s Office for Community Child Health (the Office), accomplishes this through our application of quality improvement methodology to change practice.

The program, originally named Maintenance of Certification (MOC), launched in 2013 after it was approved by the American Board of Pediatrics as a portfolio sponsor of pediatric quality improvement programs.  In close collaboration with the Child Health and Development Institute’s Educating Practices in the Community (EPIC) program, we began developing quality improvement projects that were eligible for the MOC credits that physicians need to retain licensure.  By May 2013, we had five approved projects that met MOC certification standards in our portfolio.

Originally, the Office anticipated that the program would offer projects to pediatricians primarily to enable them to fulfill their MOC requirements. However, through EPIC’s work with practices, we learned that payers are increasingly endorsing and rewarding high quality performance to align care with the goal of the Affordable Care Act of 2010.  We also learned that the National Committee for Quality Assurance’s standards require practices seeking Medical Home Recognition to engage in data driven quality improvement.

A generous grant from UnitedHealthcare allowed us to expand our focus to meet the additional needs for practicing in a dynamic healthcare environment. Practices can now use the Office’s PQI program to document quality improvement activities and to meet federal and local payer standards.

A key to our success has been the development and use of QInsight, a web-based data collection and reporting system. With the UnitedHealthcare funding, we developed and launched QInsight to provide practices with the data collection and reporting capabilities that they could not develop themselves. QInsight offers a streamlined system for practices to enter their data, generate real-time reports, document practice changes and track quality improvement project requirements. Using QInsight, practices can track their progress on implementing changes in a variety of practice areas ranging from developmental screening and surveillance to lead screening and the management of obesity co-morbidities.

In 2015, we changed our program’s title from Maintenance of Certification to Practice Quality Improvement to reflect our broad focus on supporting a variety of practice-level quality improvement activities. As a result of our efforts, an increasing number of practices are improving the care they provide to patients and are experiencing the benefits of delivering high quality health care.

The PQI program now has 24 projects that are eligible for MOC credit and meet payer and certifying organizations’ quality improvement requirements.

In addition to offering MOC credits, the PQI program also offers Continuing Medical Education (CME) credits from Connecticut Children’s for completion of quality improvement projects.

As of May 2016, 213 physicians have enrolled in our PQI program by participating in at least one of our projects. At least 172 of those physicians have received MOC and/or CME credits for their efforts.

The program has also evolved to serve as a resource to the Office and its programs, as they increasingly utilize quality improvement methodology to achieve their goals. For example, two other Office programs, the Help Me Grow® National Center and Mid-Level Developmental Assessment, are currently using the QInsight system and leveraging PQI’s expertise to monitor progress in growing their programs.

Eminet Gurganus, MPH, is the program development and implementation manager for the Connecticut Children’s Office for Community Child Health.

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