In June 2013, the Mississippi State Department of Health (MSDH) Office of Preventive Health, Chronic Disease Bureau (CDB) was awarded funding through Centers for Disease Control and Prevention to prevent and control Diabetes, Heart Disease, Obesity and associated risk factors in Mississippi. The MSDH Heart Disease and Stroke Prevention Program (HDSPP) initiated a quality improvement initiative to assist with the challenges that arise in clinical practices that health care systems alone cannot control. Some of these challenges include promotion of broad reaching systems changes, the implementation of evidence-based practices and guidelines, health information technology (HIT) and team-based care. The goals of MSQII-2 are to:
- Increase implementation of quality improvement processes in health systems.
- Increase use of team-based care in health systems (Nurses, Pharmacists, Nutritionist, Physical Therapists, Patient Navigators, and Community Health Workers).
- Increase use of lifestyle intervention programs such as Diabetes and Chronic Disease Self-Management programs.
- Increase the use of health-care extenders in the community in support of self-management of high blood pressure and diabetes.
The HDSPP convened subject matter experts (SME) and created the Mississippi Quality Improvement Initiative II (MSQII-2) Leadership Team. Through this invaluable collaboration, the MSQII-2 curriculum and a Funding Opportunity Announcement was developed in June 2014 to identify five (5) primary care organizations with multiple clinics: Three (3) Federally Qualified Health Centers (FQHCs), (1) Rural Health Clinic (RHC), and (1) Private practice clinic were awarded to participate in Cohort 1. Since the inception of the MSQII-2, the MSDH Office of Preventive Health, Chronic Disease Bureau (CDB) was awarded supplemental funding in 2015 to expand the initiative. Six (6) additional organizations with multiple clinics were awarded to establish Cohort 2: Four (4) FQHCs, one (1) RHCs, and one (1) Rural Hospital with multiple sites.
MSQII-2 is a systematic approach to healthcare quality improvement in which organizations and providers test and measure practice innovations, then share their experiences in an effort to accelerate learning and widespread implementation of successful change concepts and ideas.
The structure of MSQII-2 is based on the Institute for Healthcare Improvement (IHI) Breakthrough Series (BTS) Learning Collaborative model, which uses Associates for Process Improvement’s (API) Model for Improvement methods for organizational quality improvement. The Learning Collaborative model organizes multiple groups with varying needs into a process of group learning, where all teams use the model for improvement and learn from each other. The main components of the program model are the following:
- Organize a team to improve care.
- Attend Learning Sessions where experts share information and approached to improvement changes.
- Implement and test changes following each learning session.
- Share the teams’ results and lessons learned of the collaborative.
- Widespread implementation of successful change concepts and ideas.
During the nine month duration of the MSQII-2, clinical teams participate in Pre-Work, Learning Sessions, monthly calls, webinars and on-site visits. Participating organizations work and report on required clinical measures and narrative reports.
The Bureau of Primary Health Care initiated the Health Resources and Services Administration (HRSA) Health Disparities Collaboratives (HDC) in 1998 to help establish BPHC-supported health centers as leaders in managing quality improvement, to move toward the elimination of health disparities in our nation and to ensure excellence in practice. The purpose was to improve health outcomes for under-served people and eliminate health disparities.