GOOD NEWS: How the Baylor Health Care System Disseminates Quality Improvement (Part III)

(This is the sixth and final installment of our blog series on our recent papers on health care quality published by The Commonwealth Fund. Last week we focused on the Hill Physicians Medical Group. This week we look at Baylor Health Care System, a nonprofit integrated delivery system based in the Dallas/Fort Worth area.)

We've already learned about Baylor's Best Care Committee and its physician champions. Now let's wrap up with a look at Baylor's innovative training program and the exportable lessons.  

ABC-Baylor

As you know, senior members of Baylor and its HealthTexas Provider Network traveled to Intermountain Health Care in Utah several years ago to see first hand the systemic quality improvement that reformed its delivery of health care. Inspired, the attendees returned to Baylor and created the Physician Champions program and their own Quality Improvement education program.

Patterned after the Intermountain model, Accelerating Best Care at Baylor (ABC-Baylor) began in January 2004 with help from Intermountain's Brent James. It features a six-day seminar designed to provide the tools for rapid-cycle process improvement throughout the Baylor system. When physicians and other health care professionals have data, strategy, and a goal, the health of their population can improve.

As an additional incentive to its providers, Baylor's Quality Improvement Award Program offers multidisciplinary teams cash prizes for demonstrating sustained quality improvement. More than 600 clinicians, administrators, and board members have graduated from the full six-day ABC Baylor course, and more than 500 unit nurses have completed ABC Fast Track, the one-day accelerated version of the program.

Three Exportable Lessons

Physician Leadership Is Critical. Baylor administrators get physician cooperation in part because they pay for it. As described earlier, the Physician Champions program pays early adopters of quality initiatives and EHRs on a part-time basis to positively influence their peers. As Dr. Couch, the lead Physician Champion, states: "It is unrealistic to expect practicing physicians to dedicate significant time to help the healthcare system advance quality unless compensated for that time."

Board Leadership Is Critical. Baylor's Boards of Trustees have made quality improvement a priority. Their leadership includes setting targets for reducing mortality, as well as setting participation goals for such quality initiatives as the Institute for Healthcare Improvement's 100,000 Lives Campaign. Similarly, a staffer for Premier, Inc. reported that board commitment was essential for success in its Hospital Quality Incentive Demonstration project.  A priority for the board becomes a priority for the organization.

Quality Needs an Answer to "Who Says?" The Best Care Committee is the clinical authority for the entire Baylor system. Its research, deliberations, and decisions are based on the tools Physician Champions use to improve the quality of care that the patients receive. In addition, information about evidence-based medicine needs to be available to Physician Champions so that they can work with their peers.

You can find the overview for this series here, and the Hill posts here and here.