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DRAFT---Regional Coordination for Healthcare Innovation_042211

DRAFT---Regional Coordination for Healthcare Innovation_042211

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Published by Michael Painter

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Published by: Michael Painter on Apr 22, 2011
Copyright:Attribution Non-commercial


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A concept: Support for sustainable regional health care improvement
 To: a) prioritize coordination among existing national initiatives focused on regional health careimprovement; b) promote the development of strong regional leaders and leverage partnershipswith regional leaders to help drive sustainable improvement; c) capture knowledge andexperience gained through these initiatives and spread that knowledge within and beyondcurrent participating communities; d) ensure readiness for reform in other geographic regions;and, d) foster networking among national and regional leaders in a wide range of communitiesseeking to improve cost and quality of care.
 The Robert Wood Johnson Foundation/Aligning Forces for Quality, The Agency for HealthcareResearch and Quality/Chartered Value Exchange, and the Office of the National Coordinator for Health Information Technology/Beacon Communities; Network for Regional Health CareImprovement, Key Regional Leaders.
 Independently, the major initiatives have supported an aggressive agenda to partner with andassist local regional leaders to promote sustainable improvement in quality and cost of care intargeted communities. Together, these national initiatives working with their local partners canand must work together to build on these successes to enhance coordination of those efforts,ideally, establishing a community of regional leaders across America. This work will besupported by the tested resources and technical assistance of each partner and itscollaborators, but led increasingly over time by the communities themselves. Leveragingknowledge gained by existing regional reform efforts²and spreading to other regions equallypositioned for change²will help communities across the country make substantial progresstoward achieving sustainable high value care.
  A number of major national initiatives are bringing or attempting to bring an unprecedentedcommitment of resources, expertise and training to help leaders in local and regional healthcare markets dramatically improve the quality and cost of care. Participating communities havealready achieved a great deal and are now working even harder to make significant progress intheir regional efforts. These large national initiatives importantly demonstrate that reform canand probably must unfold region by region. For that to happen, local or regional multi-stakeholder leaders need to design and implement changes in the way their respective marketorganizes, delivers and pays for health services. While these initiatives have much in common,each has a unique emphasis and strengths and growing areas of expertise. These initiativesalso cover similar but not exactly the same geographic areas or types of regional entities.
Further, the regional leaders, themselves, have developed their own significant experience andexpertise regarding specific aspects of necessary reform.
Necessary But Not Sufficient.
Much has been accomplished in recent years. However, theseinitiatives highlight that long term, sustainable improvement cannot rely solely on strong nationalleadership. The success of these national efforts also cannot rely on strong partnerships withcapable, multi-stakeholder local leadership. National and regional leadership matters²but thespecific activities driving toward the improvement do as well. For instance, all these initiativeshighlight that it is not sufficient for a regional effort to focus simply on one area of improvementat a time such as improving key tools like health information technology or getting better atsupporting quality improvement or ensuring widely available public information about the qualityand cost of care. All of the major initiatives promote a concerted focus on a suite of relatedsimultaneous activities. That concerted effort is hard, complicated, expensive work.Nevertheless, in spite of the enormous task, the regional reform movement is robust and readyto take on the next set of challenges. Both regional leaders as well as national leaders in theseinitiatives recognize that while there are many pending challenges, several major areas of needare particularly important including these two:1.
Assistance for communities outside the current cohort of regional initiatives
. Incommunities across the nation, key stakeholders are already collaboratively improvingkey aspects of their health care markets. Many communities that were unsuccessfulBeacon Community applicants, for example, demonstrated the capacity and will for change.
2. Enhanced coordination and collaboration among existing regional efforts.
To date,existing programs, like Aligning Forces or the Beacon Community program, haveunderstandably had stringent enrollment criteria and fairly competitive selectionprocesses for participation. Organizers have relied largely on a closed architecture witha central program office serving as the link among participating communities. Because of the importance of this regional work, its many difficult aspects, the steep learning curveand vast need for technical resources, it is in the strong national and local interest, thatthe existing initiatives coordinate efforts, share learning and align assistance, wherepossible. It is also critical that these national efforts and the local leaders from thefrontline communities in those efforts find ways to share their hard won expertise,experience and wisdom with other communities to assist those markets as they attemptsimilar work. The nation cannot afford to recreate this critical learning market by market,place by place. The need for rapid innovation and spread of that innovation is too great.In the future, the major national initiatives will coordinate and collaborate extensively.Local community leaders, themselves, will assume greater responsibility for the designand management of this work. This standard of regional and national coordination willencourage self-organization, peer-to-peer knowledge transfer and co-creation of solutions by and among community leaders around common issues.
 AIM 1 . Leverage knowledge gained through existing initiatives for spread within and beyond current participating communities.
A series of practical best-practice reports
on key topics, based on successful modelsemployed by local leaders.
Use appropriate social media tools
to promote and create where possible vibrant,virtual, open learning communities.
A living database
of community objectives, measured outcomes and key strategies.4.
A showcase and story database of community successes
in online forums andmeetings.5.
Advocacy and shaping of policy agendas
in accordance with the aims and challengesidentified by communities.6.
An online clearinghouse of community-level strategies
and best practices in apractical, action-oriented format.7.
A common research agenda
for investigating models, barriers and facilitators for regional healthcare change.8.
Leadership Forums
hosted by a community with demonstrated success in a key areaof work. For example, in
11 the Indiana Health Information Exchange hosted aLeadership Forum on leveraging HIE¶s for performance measurement and paymentreform. Similarly, the Minnesota Community Measurement could host a LeadershipForum on public reporting and consumer engagement. Hosting the Forums locally in a³delegated learning model´ provides an opportunity for attendees to interface with anumber of key staff and stakeholders, to understand both the work and communitycontext, and to interact in smaller groups of stakeholders who can work together to takepractical lessons to their own communities.
 AIM 2. Manage a Peer-to-Peer Network of Community Leaders
Open the meetings, web resources, training and technical
assistance to any and allcommunities.
Aggressively deploy social networking tools
to facilitate networking and knowledgesharing among community leaders.
Work with community foundations and others to support work in localcommunities
and leverage resources and participation particularly regardingsustainability of regional.

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Jim Bailey added this note
Again "coordinate efforts" is better than "enhance coordination of efforts"
Jim Bailey added this note
AIMS a) coordinate -rather than "prioritize coordination among"

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