Quality Improvement & Programs

 


The Quality Improvement Department provides technical assistance and training to health centers to support improvements in access, operational excellence, and health outcomes. Through our partnerships with experienced content experts, we develop and facilitate training sessions, conferences, on-site technical assistance, and peer groups to accelerate the use of innovative and evidence-based best practices.  We help health centers leverage data and HIT to improve care processes and outcomes, and prepare providers for alternative delivery and payment systems. Our areas of focus include quality measurement, quality improvement techniques, PCMH & team-based care, care management & coordination,  chronic disease, cancer prevention, behavioral health integration, oral health integration, emergency preparedness, value-based payment, and special populations. 

Click below to learn more: 

 

Technical Assistance and Training

Our work as a QI Department is focused on supporting community health centers in developing, implementing, and sustaining improvements in health center operational excellence and patient access, equity, and outcomes.

Our team provides trainings, technical assistance, tools, and formal forums for collaboration to expand health center capacity to meet the challenges and opportunities of a rapidly changing healthcare environment. Through our partnerships with an array of subject matter experts locally and nationally, we help health centers accelerate their use of innovative and evidence-based best practices.  We offer in-person and web-based training sessions for individual health centers as well as joint trainings for all health centers. Through our customized technical assistance, we support the implementation of evidence-based practices and provide opportunities for shared learning.

We bring the following strengths to our technical assistance and training offerings:

We are here to support our health centers.

Listed below are current areas of focus for our training and technical assistance:

Quality Improvement Techniques & Tools

Our team utilizes the Model for Improvement to guide all our work and to help health centers achieve their goals. The Model for Improvement is a quality methodology for rapid-cycle improvements developed by the Associates in Process Improvement.

We regularly offer a 3-hour QI Bootcamp training as well as shortened (30-min to 1-hr) versions that can be provided on-site. Our trainings are skills-focused, providing guidance on the use of evidence-based quality tools.

Through our training and technical assistance to health centers, we provide guidance on all aspects of the quality improvement cycle including:

  • Setting Aims
  • Establishing Quality Measures
  • Selecting Changes
  • Testing Changes
  • Implementing Changes
  • Spreading and Sustaining Changes

Patient-Centered Medical Home Transformation (PCMH)

Our team is committed to assisting member health centers to transform the delivery of primary care by following the Patient-Centered Medical Home (PCMH) principles and guidelines which increase quality, improve health outcomes and manage costs. These principles center around taking a team approach to primary care, aim for systems change by implementing the Care Model, and also include the integration of the Improvement Model for quality methodology.

As of 2018, 7 of 8 District FQHCs hold PCMH recognition with 19 certified sites at level 2 or 3. In supporting health centers in their work as a medical home, DCPCA seeks to advance the utilization of team-based care models, strengthen health center readiness for the PCMH recognition process, and enhance integration of care internally and with the broader medical neighborhood.

Care Management & Coordination

DCPCA supports staff on a range of care management and coordination topics including establishing a multi-disciplinary team; preparing an effective communication structure; determining a care planning, management, and graduation plan; improving patient education; streamlining team processes, and executing warm-hand offs between medical providers and other staff.

DCPCA, in partnership with the DC Department of Health Care Finance (DHCF), supports health centers in their implementation of the MyHealthGPS program, began July 2017. As part of the District’s My Health GPS program, interdisciplinary teams embedded in the primary care setting will serve as the central point for integrating and coordinating the full array of eligible beneficiaries’ primary, acute, behavioral health, and long-term services and supports to improve health outcomes and reduce avoidable and preventable hospital admissions and ER visits. 

Chronic Disease

Please see Million Hearts for more information on our training and technical assistance for diabetes and cardiovascular disease.

Cancer Prevention

Please see Cancer Prevention for more information on our training and technical assistance provided through our DC3C Cancer Prevention project and MedStar-DCPCA Cancer Navigation project.

Behavioral Health Integration

Behavioral health integration is about bringing together behavioral health and medical health providers to improve outcomes and enhance the efficiency of the delivery system. Through a coordinated delivery model, patients are given improved access to mental health services. DCPCA supports health center efforts to integrate mental health services into a primary care setting by coordinating cross-center peer sharing to explore shared challenges, opportunities for collaboration, and systems-level solutions.

DCPCA conducts regular trainings on core topic areas supportive of behavioral health integration. Additionally, DCPCA facilitates an active Behavioral Health Peer Group, a forum for practice improvement, information exchange, support, and strategy.

Oral Health Integration

Many of our health center members provide oral health care within the primary care setting. We seek to provide learning opportunities that will enable health centers to support a financially sustainable oral health program, increase access to care, improve coordination with community partners, and improve quality outcomes.

DCPCA facilitates an Oral Health Peer Group, a forum for health center staff to share best practices and exchange key resources.

Emergency Preparedness

Our goal is to support our member health centers with acquiring the appropriate resources and capability to prepare for, respond to, and recover from emergencies. Working closely with DC Health’s Health Emergency Preparedness and Response Administration (HEPRA)  DCPCA aims to ensure health center sustainability and support continued integration of the District’s emergency operations plan.

Value-Based Payment

Beginning September 2014, DCPCA launched its value payment reform initiative, focused on FQHC awareness and readiness to thrive in a health system moving to value. Our goal is to best position health centers to drive their destiny in the increasingly competitive and demanding health eco-system of the District of Columbia.

In support of that goal, DCPCA provides training on practice transformation and technical assistance regarding population health, quality measurement, and HIE tools, including the following: 

  • Clinically integrated network project: DCPCA facilitates the DC Coordinated Care Network (DC CCCN) an initiative of seven FQHCs charged with creating an integrated care system, with a coordinated set of interventions, to improve quality while reducing costs. Primary care should be at the center of health investment and improvement, and the District’s FQHCs believe that their best chance to thrive as high-quality safety net providers is together.
  • DC FQHC Pay-for-Performance (P4P) Program:  DCPCA coordinates with Department of Health Care Finance (DHCF) to provide guidance to health centers on performance measurement and practice transformation to support the goals of the P4P program. In 2018, DHCF implemented a new Medicaid reimbursement methodology for FQHCs, to replace a Prospective Payment System (PPS) reimbursement model in place since January 2001. One component of this model includes an additional payment based on performance of each FQHC. In implementing this new P4P program for FQHCs, the goals of DHCF are to:
    • Improve the health of Medicaid beneficiaries accessing services at FQHCs in the District; and
    • Incentivize primary and preventive care over ED visits and inpatient admissions.

Please see the HIT Department pages for more information on our support of HIE and HIT tools to drive population health assessment and improvement.

Special Populations

The Health Resources and Services Administration (HRSA) requires Primary Care Associations (PCAs) to develop strategies for addressing the unique health needs and barriers to care for special populations in the state/region. The majority of Health Center Program grantees are funded to serve a general underserved community or population; however, some grantees receive funding to specifically target one of three statutorily recognized special populations: migrant and seasonal farmworkers and their families; persons experiencing homelessness; and/or residents of public housing.

DCPCA works with member health centers to provide technical assistance and training on the following special populations: homeless populations, and individuals in public housing. In working with health centers, community-based organizations, and District partners, DCPCA seeks to identify best practices and advance the implementation of those strategies across the health center network.

 

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Peer Groups

The QI Department seeks to provide forums for connection between and among health centers -- allowing health center staff to learn from each other’s best practices and enhance strategic partnerships to meet common goals.

In support of this vision, the QI Department organizes and facilitates Peer Groups organized around common topics. Peer Groups are open to all health center staff, including clinicians and administrative staff. Meetings provide a forum for shared learning as members share their best practices, including processes, tools, and resources. Peer Groups allow staff to identify key challenges and propose coordinated systems-level solutions.

Peer Group facilitators frequently bring in subject matter experts as guest speakers including those from academia, government agencies, community-based organization, and national healthcare bodies.

We welcome health center staff participation in the following active Peer Groups:

  • Behavioral Health (monthly meetings)
  • Workforce Development (monthly meetings)
  • Oral Health (quarterly meetings)
  • Patient Navigators for Cancer (quarterly meetings)
  • Emergency Preparedness (quarterly meetings)
  • Finance (ad-hoc meetings)
  • PCMH (ad-hoc meetings)
  • *Coming Soon* Medical Directors (quarterly meetings)

Please see our Training & Events Calendar for the next scheduled Peer Group meeting. We also include the upcoming meeting schedule in our Training Newsletter sent the first week of each month.

For additional information or to join an existing Peer Group please contact our Training and Programs Manager, Emily Long, at elong@dcpca.org.

 

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Data Analysis & Quality Measurement

DCPCA supports health centers in using data to drive improvement in the delivery of primary care and health care outcomes. Our QI Department works closely with our HIT Department to use data to inform technical assistance and training and support health center’s goals.

Through technical assistance and training, DCPCA supports health center staff in:

  1. Measuring their quality and performance on a range of measures, including UDS measures; and
  2. Optimizing their use of the EHR, the HIE and other HIT tools to drive individual health center and system-level improvement.

This work assists health centers in achieving quality improvement awards from HRSA, obtaining Meaningful Use Incentive Payments and achieving Patient-Centered Medical Home (PCMH) recognition.

Our work in this area expands health center capacity to meet the challenges and opportunities of a rapidly changing healthcare environment. By providing health center staff with tools to assess population health data and advance their ability to analyze that data, providers are better equipped for alternative delivery and payment systems.

Please read more about our departmental programs for information on how data is used to support the achievement of health center goals: