The Quality Improvement Collaborative (QIC) concept was introduced in the 1980s and allowed providers to focus on specific quality metrics, share experiences, research, and best practices. A systematic review of the QIC (Susan Wells et al, 2018) showed 83% of studies about QICs to significantly improve targeted clinical processes and patient outcomes. However, Wells’ review points out that traditional QICs face several challenges, including significant time and capital investment, as well as low response rates from patients and providers.
While multi-center collaboratives (e.g. state-wide collaboratives, specialty collaboratives, etc.) are now a familiar forum for quality improvement, multi-center collaboratives have only focused on clinical outcomes (e.g. complication rates) - but not yet patient-reported outcomes (PROs) to improve quality.
Leveraging PROs for Quality Improvement Collaboratives
Meanwhile, there has been a growing effort by providers to leverage Patient Reported Outcomes (PROs) to improve perioperative care. However, the benefits of PROs have not been fully realized because PRO data collection is usually limited to:
- A few time points of the surgical continuum (e.g. one time point at 30 days post-discharge only)
- Single PRO measures (e.g. Quality of Life only)
- Single center data collection (e.g. no multi-center benchmarking)
However, providers could achieve real improvements in quality if PROs were used in a more comprehensive manner, such as:
- Collecting PROs regularly (e.g. sometimes daily) across the continuum (pre-op, in-hospital and post-discharge)
- Collecting multiple PRO measures (symptoms, functional status, protocol compliance)
- Benchmarking the same PROs across multiple centers to drive quality improvement
Patient engagement technology such as SeamlessMD presents a unique opportunity to achieve these benefits.
Introducing SeamlessMD PRO Quality Collaboratives
Today, SeamlessMD is proud to introduce multi-center, PRO quality collaboratives where providers using the SeamlessMD platform can:
- Dashboards to benchmark patient-reported outcomes (PROs) - e.g. pain scores, opioid use, protocols compliance, etc.
- Share best practices - providers from different centers hold monthly conference calls to review the benchmarking dashboards and learn from high performers. E.g. centers with higher pain scores learn pain management practices from centers with lower pain scores
- Compare pathways and protocols - e.g. learn about new protocols other centers are seeing success with
- Advance thought leadership - present and publish original, multi-center PRO research based on the data collected on the SeamlessMD platform
Real example: Cardiac Quality Collaborative on SeamlessMD
The SeamlessMD Cardiac Quality Collaborative launched in 2018, led by the cardiac centers at Baystate Health, Montreal Heart Institute and Prairie Heart Institute.
Surgery and nursing providers from these centers meet once a month via conference call to benchmark and discuss PRO performance by using custom, benchmarking dashboards on SeamlessMD. PROs benchmarked include pain, anxiety, mobilization, etc. These interdisciplinary teams from the centers use the dashboards to identify high performers and those high performers share to achieve better outcomes. This allows participating teams to get better together and advance thought leadership in their respective arenas.
The benefits of this novel PRO quality collaborative have been tremendous and Dr. Louis Perrault (Chief of Cardiac Surgery, Montreal Heart Institute) is presented these efforts at the 2019 AATS annual symposium.
Dr. Perrault’s presentation on will take place May 4 between 8:00 AM – 9:45 AM, at AATS 2019, and is called “Patient Reported Outcomes for Quality Improvement and Enhanced Patient Safety in Cardiac Surgery: A Multi-Center Collaborative Project”.
For the official AATS abstract, click the link below: https://www.aats.org/aatsimis/AATS/Meetings/Active_Meetings/2019/99th_Annual_Meeting/AATS_99th_Annual_Meeting_Abstracts/2019-A-1874-AATS-28.aspx
Interested in learning more about PRO Quality Collaboratives?
Besides Cardiac Surgery, SeamlessMD has launched PRO Quality Collaboratives with partners in other clinical areas, with more on the way.
If you’re interested in learning more about how these PRO Quality Collaboratives work and getting your center involved, give us a shout!