That’s so CHIC!

By Danielle Malone, Project Manager

The CHP Health Improvement Committee, or “CHIC”, is one of three Community Health Partnership Quality Improvement Committees. At least three individuals from each clinic member organization is represented at the quarterly CHIC meetings and calls. CHP has been able to successfully nurture a culture of commitment for data driven improvement and level of accountability with constant communication with our committee members. The purpose of the CHIC is to improve patients’ health outcomes. This is achieved by discussing consortium wide quality initiatives, sharing un-blinded population level quality data (the CHIC dashboard), developing working relationships with individuals at other member organizations; and discovering, discussing, and spreading better practices.

Annual Work Plan

CHP creates an annual work plan at the beginning of each calendar year. The annual work plan is reviewed with the Data Committee, CHIC, and the CHP Board of Directors during the first quarter of the calendar year. The plan outlines proposed QI objectives and activities for the ensuing year.

2020 Work Plan Objectives

Objective 1

Data Analytics – Expanding the skills of care teams to make data-driven decisions by improving their capacity in real-time data analytics and reporting.

Objective 2

Sustaining the adoption of population health management by advancing the clinics’ capacity in the first 5 Building Blocks of high performing primary care.

Objective 3

Workforce Development/Training – To create a high performing workforce that works at the top of their job description and uses data to improve clinical outcomes and patient experience. Expanding the skills of care teams to make data-driven decisions by improving their capacity in real-time data analytics and reporting.

Objective 4

To be South Bay leaders in ongoing clinical transformation by supporting clinics’ assessment and continual improvement in the way patient care and experience is delivered at all levels in a care delivery organization. 

Community Health Partnership utilizes a variety of methodologies to achieve our objectives as outlined in the annual work plan and to support our member community health centers’ efforts to improve performance. These include quality improvement, practice redesign, population health management, and performance tracking and reporting.

The CHIC Dashboard

A number of nationally recognized organizations such as the Agency for Healthcare Research and Quality (AHRQ) and the National Quality Forum (NQF) have endorsed the use of valid and reliable measures of quality to improve health care. A dashboard of 10 measures are used to show performance on quality metrics by our member organizations. The list of quality metrics is developed by CHP staff, discussed and approved by the CHP Data and CHIC Committees, and incorporated into the CHIC dashboard on an annual basis. When possible, the measures conform to locally and nationally recognized definitions such as those contained in Meaningful Use (MU), Uniform Data System (UDS), and Healthcare Effectiveness Data Information Set (HEDIS) reports.

Clinic staff submit quarterly aggregate data, based on trailing year to CHP. The dashboard is used to establish baselines, benchmarks, highlight best practices, and to track quality improvement efforts. The dashboard is updated quarterly and shared at the CHIC, Data Committee, and CHP Board of Director meetings. Dashboards are password protected and located on the CHP website.

Highlights of 2020 so far (metrics able to maintain despite COVID)

The start of our new data collection for calendar year 2020 was met with the onset of COVID. Despite this CHP’s members were able to maintain cervical cancer screening (65%), early entry into prenatal care (78%), HIV screening (31%), and have shown an improvement in colorectal cancer screening (improving from 47% to 49%).

There was a slip in childhood immunization status (46%), but it looks like the performance has made a significant improvement for this quarter (56%), surpassing the performance from a year before (49%). This might be due to the increased push that clinic members are making to close the care gap that was created from COVID.

As predicted our priority measure for the last three years, breast cancer screening, is showing a decrease in performance. We are seeing a dip in chronic care management metrics, as shown in the Diabetes A1c <8% metric in the graph above. There has also been a very slight decrease in weight screening for children and adolescents, dropping from 62% to 61%.

Best Practices

Through our best practice initiative, CHIC promotes member and external organization best practices. CHP integrates best practice opportunities into CHIC activities and facilitates site visits to best practice organizations.

Telehealth Focus

As CHP continues to build out our best practice program we have had the opportunity to highlight telehealth even more with the advent of COVID 19. CHP believes telehealth is an integral part of patient-centered care and we are accelerating and advancing our initiatives to support the surge in telehealth demand and use across health care.

We know telehealth is a big priority for all of our clinic members right now and we understand the important role telehealth has played in making care available amid an unprecedented shelter in place, and that it will continue to be an important part of the healthcare system going forward.

As we continue to provide telehealth services and clinics continue to work on engaging patients back into face-to-face care, through CHIC we have been exploring and providing opportunities to discuss telehealth challenges and innovations. During our CHIC meetings and calls we have facilitated dialogs around how telehealth care is being provided at health centers, how to measure telehealth care, what challenges are being encountered in providing chronic care management to patients via telehealth and how can we best support our workforce during this time.

We are engaging our clinic members in telehealth projects and quality improvement efforts to learn more about telehealth care delivery, processes and capabilities and help us shape future care frameworks. This has been an opportunity to learn from best practices in managing cardiovascular risks using telehealth.

CHP will continue to advocate, at various policy levels, for the work that our clinic members are doing, the need and the value to continue telehealth care delivery.