Translating Research into Practice and Policy
Network-based, multi-site improvement and research: finding and testing new approaches to care delivery
Ohio Perinatal Quality Collaborative (OPQC)
Donovan E, Iams J, Lannon C, Rose B, Kaplan H, Bailit J
Begun in 2007, the Ohio Perinatal Collaborative is an Ohio-based network of perinatal care providers that aims to identify and apply effective methods to reduce preterm birth and morbidity and mortality in Ohio. OPQC has received funding from the Ohio Department of Job and Family Services through a contract with Center for Medicaid and Medicare Services to support two quality improvement efforts:
- Neonatal: 24 neonatal units are testing strategies to reduce late-onset (>72 hours) blood stream/CSF infections in infants 22-29 weeks gestational age by 50%
- Obstetrics: 22 obstetrical teams are testing strategies to significantly reduce the number of women in Ohio of 36 to 39 weeks gestation for whom initiation of labor or caesarean section is done in absence of appropriate medical or obstetric indication.
These projects are focused on creating perinatal communities within the state of Ohio focused on developing and testing strategies to address specific clinical issues, spreading improvements shown to be effective, and developing a model for collaborative improvement of perinatal care. State agency partners include the Ohio Department of Job and Family Services and the Ohio Department of Health.
Joint Council on Congenital Heart Disease (JCCHD) QI Initiative
Beekman R, Lannon C, Jenkins K, Klitzner T, Kugler J, Martin G, Neish S, Rosenthal G
The JCCHD brings together prominent national leaders from medical and surgical specialty organizations to collaborate in caring for children with congenital heart disease. One of its initial efforts created a QI Task Force in 2006 that has designed the JCCHD National Collaborative for Improvement in Pediatric Cardiovascular Disease. Its mission is to dramatically improve the outcomes of care for children with congenital heart disease through a national collaborative network of providers working together to collect longitudinal data and conduct improvement research intended to accelerate the development and translation of new knowledge into practice. The initial project focuses on infants with hypoplastic left heart syndrome. A pilot test of a registry and identification of useful strategies is currently underway with six pediatric cardiology centers; recruitment for the network is underway, with the initial meeting planned for summer 2009.
Early Developmental Screening and Intervention (EDSI)
Inkelas M, Margolis P, Kahn R, Froehle C
The Early Developmental Screening and Intervention (EDSI) project is a strategic partnership supported by First 5 LA to improve early identification and promote healthy development of young children in Los Angeles County. This five-year, $5.5 million project includes three interrelated, coordinated strategies: 1) promoting a policy agenda that supports the desired community changes, 2) piloting a new parent education curriculum on how parents can talk to their physicians about their child’s development, and 3) engaging pediatric care and early care and education providers in structured community-based learning collaboratives toward establishing a set of system improvements. Now in its third year, the project is spreading improvements in preventive and developmental services delivery to practices throughout Los Angeles in partnership with the local American Academy of Pediatrics chapter, and conducting a population-based intervention to work across health, social services and educational sectors to improved early developmental outcomes for a defined population of children.
Autism and Developmental Screening Learning Collaborative (ADSLC)
Duby J, Lannon C, Fuller S
The ADSLC is a collaborative initiative among the Ohio chapter of the American Academy of Pediatrics, the Ohio Department of Health, the Ohio Department of Job and Family Services, and CHCQ. The ADSLC mission is to measurably improve developmental outcomes for young children in Ohio through the appropriate identification, assessment, and referral of young children with, or at risk for, delays in practice settings that care for young children. This pilot project involves five Ohio communities. Teams from 28 pediatric, family medicine, and academic medical center practices from 16 counties and surrounding areas attended a 1.5 day learning session in fall 2008 to learn about implementing office systems for developmental and autism screening, linkages for effective referral and evaluation services, and how to use improvement science methods to make changes to their current delivery care system. The teams will be supported through conference calls for six months, through spring 2009, to help them incorporate the changes they learned and to spread these within their practice. Evaluation will involve multiple levels: parent feedback, practice-based performance, referral patterns in the statewide early intervention database, and Medicaid claims regarding developmental screening and evaluation. Based on findings from the pilot work, a plan for spread throughout Ohio will be developed and implemented in 2010.
