The Greater Boston Aligning Forces For Quality Initiative


About the Greater Boston Aligning Forces For Quality Initiative

The Greater Boston Aligning Forces for Quality (GB AF4Q) Initiative works to develop a health care delivery system in Massachusetts where patients receive the right care at the right time in the right place. With support from the Robert Wood Johnson Foundation, this collaboration of key stakeholders aims to:

    1. Reduce rates of non-urgent emergency department (ED) use by understanding and addressing patient drivers and reducing system and population-based barriers to primary care;

    2. Reduce preventable ED visits, hospital admissions and readmissions for patients with ambulatory care sensitive conditions;

    3. Increase compliance rates with recommended treatments and measurably improve outcomes for diabetes, pediatric asthma and hypertension;

    4. Improve care experiences and patient engagement in ambulatory settings; and

    5. Improve collection and use of standardized race, ethnicity, language and level of education (RELE) data for ambulatory care patients to reduce disparities in care and outcomes.

GB AF4Q Activities

Targeting our efforts on the interface between primary care and emergency care presents an important opportunity to improve quality, equity and access for patients, as well as reduce costs. State data indicates that nearly half of ED visits are deemed avoidable and account for 13 percent of preventable hospitalizations. Areas with medically underserved populations consistently have higher rates of preventable ED use.

Beginning first with diabetes, pediatric asthma and hypertension, we plan to build and implement a sustained effort to improve ambulatory care and avoid preventable ED and hospital use. All three conditions have high rates of prevalence in the Greater Boston area, with higher rates of incidence in minority populations. Using several tools, including performance measurement and reporting, quality improvement, payment reform and health information technology, GB AF4Q will implement a sustained effort to improve ambulatory and hospital care services around these conditions. GB AF4Q is:

  • Working with health care organizations to give clinicians the tools to identify individual care practices needing improvement, including chronic disease management, ED utilization and improved outcomes for patients. Our Practice Pattern Variation Analysis and Reporting initiative will convene a Clinical Leaders Workgroup across Greater Boston’s many clinical institutions that will develop and pilot a process for identifying opportunities for improvement and best practice solutions and coming up with ways for integrating this information into practice. GB AF4Q will also establish an ambulatory quality improvement infrastructure to engage physician practices in supporting these and other improvement efforts.
  • Developing an improved public reporting website to inform patients and the public about quality and cost information and help them make better health care decisions. The website will include new practice-level clinical quality, patient experience and cost measures.
  • Creating a Greater Boston Health Equity Dashboard to stratify quality care measures related to diabetes, pediatric asthma and hypertension by race, ethnicity, and language. Greater Boston health care institutions will pilot the health equities dashboard to evaluate its usefulness in helping to pinpoint and take action to improve disparities in care.
  • Educating stakeholders about ongoing payment reform activities in Massachusetts. GB AF4Q will develop strategies to ensure that the priorities of performance measurement and public reporting, quality improvement, consumer education and reducing disparities are part of payment reform in Massachusetts. GB AF4Q will launch a campaign to educate the public about the goals of payment reform and how it can improve the state’s health care delivery system.
  • Spearheading statewide efforts to create a common vision and language around the role that patients and the public play in creating a patient-centered system of care. This includes the development and implementation of targeted campaigns to increase the use of patient portals and personal health records, and educating patients about using primary care resources instead of emergency departments.
  • Conducting an assessment of current asthma and diabetes registries and developing a three- to five-year plan for achieving a community-based chronic disease registry in Greater Boston. Expanding registry capabilities will provide timely measurement and feedback to clinicians, improve identification of disparate patterns of care and help to identify the best care management practices.

Greater Boston Aligning Forces For Quality Leadership

GB AF4Q will draw on the community’s collective expertise to develop solutions that work. Led by Massachusetts Health Quality Partners and the Alliance for Appropriate and Affordable Healthcare (Triple A-H), the GB AF4Q governance structure aligns organizations and collaboratives in the area to advance health care quality and equity and reduce costs. The 35-member Leadership Team represents a diverse group of stakeholders from across the continuum of health care delivery, public health and community settings, as well as leaders of collaboratives for quality improvement, consumer engagement, advocacy, and employer interests. GB AF4Q joined Triple A-H’s Payment Reform Working Group and the Boston Public Health Commission’s Health Equity Committee to address issues of cost containment and disparities in health care. In 2011, additional workgroups will be established to support ambulatory quality improvement and consumer engagement objectives.

Support from the Robert Wood Johnson Foundation

Greater Boston is one of 16 communities across the country participating in the Aligning Forces for Quality (AF4Q) initiative—the Robert Wood Johnson Foundation’s premier effort to lift the overall quality of health care in target communities across the country. Participation in this project brings an unprecedented commitment of resources, expertise and training to the Greater Boston health care community to turn proven practices into real results on the ground. For more information about GB AF4Q, please contact Leslie Kirle.


About the Greater Boston Aligning Forces for Quality Initiative

Press Release: Greater Boston alliance receives $1.3 million to lift the quality of Boston’s health care

 

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