Accelerating Quality Improvement Through Collaboration (AQIC)

This is archived content, for historical reference only.

Community clinics and health centers provide care for the state’s uninsured and low-income residents and play an important role in the health care safety net. These centers provide care for an estimated four million Californians annually, including a large population with diabetes. National studies show that patients with diabetes and other chronic diseases generally receive recommended care only about half of the time, and even less so when patients are uninsured or underinsured. Better care requires a more planned and systematic approach to diabetes across all safety-net clinics.

To spur the adoption of quality improvement methods and the use of electronic data by community clinics and health centers, CHCF funded the $1.9 million, two-year Accelerating Quality Improvement through Collaboration (AQIC) project, which ran from February 2007 until January 2009.

The statewide effort implemented a common quality reporting system and processes for improving diabetes care across community clinics and health centers. It was coordinated by the California Primary Care Association (CPCA) and managed in collaboration with 14 regional health center consortia. Initially, four clinical data measures relating to diabetes care were collected and analyzed. Clinical data for patients were collected and reported to the consortia, which reported them to CPCA at the statewide level — to aggregate and then monitor quality improvement across California. In addition, each consortium focused on specific activities based on the data collection capacity of participating health centers. Consortia, working with health center staff, developed plans to broaden and strengthen quality improvement activities at each health center through a “quality improvement spread plan” at the health center organization and at the consortium level.

As the AQIC project progressed, additional clinical measures on other chronic diseases and preventive care (pediatric immunizations, pap tests, and mammograms) were considered for reporting through the AQIC project, and two operational efficiency measures were added.

This project anticipated the following benefits:

  • Improved and more consistent patient care
  • Increased patient satisfaction with care
  • Consistent clinical data measurement to prepare health centers for participation in pay-for-performance programs
  • Increased operational efficiency
  • Increased provider satisfaction and retention
  • Improved capacity to comply with new federal reporting requirements

By advancing the use of standardized clinical measures and data reporting methods, this continuing effort is improving processes and outcomes for patients served by California’s community health centers and clinics.

Independent Project Evaluation

CHCF contracted with Jane Taylor, EdD, and Suzanne Salem-Schatz, ScD, of the HealthCare Quality Initiatives for a qualitative evaluation of the initiative to cull lessons learned by community clinics and clinic consortia. The hope is that these lessons along with lessons from the Tools for Quality Initiative, which supported the adoption of electronic chronic disease registries, will have application for the implementation of electronic health records in clinic settings. Published in April 2011, Lessons Learned from Accelerating Quality Improvement through Collaboration is available as a Document Download.