Abstract
Physicians can pursue a career in quality improvement through many types of organizations. One of the oldest and most established alternatives is the Quality Improvement Organization (QIO). This chapter will provide the reader with an overview of QIOs: historical development, types of projects performed by the QIO, roles of physicians, and skills needed to work in this field. Physicians from a variety of backgrounds use a combination of their skills, including clinical practice, administrative, research, program development, education, and evaluation skills, in performing this role. Physicians can find this work fulfilling and successfully contribute to improving systems of care for patients and care providers.
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- AAA:
-
Area Agency on Aging
- AAFP:
-
American Academy of Family Physicians
- AARP:
-
American Association of Retired Persons
- AGS:
-
American Geriatric Society
- AHQA:
-
American Health Quality Association
- AHRQ:
-
Agency for Healthcare Research and Quality
- AMA-PCPI:
-
American Medical Association – Physician Consortium for Performance Improvement
- AMDA:
-
American Medical Directors Association
- BFCC:
-
Beneficiary and Family Centered Care
- CKD:
-
Chronic Kidney Disease
- CMO:
-
Chief Medical Officer
- CMS:
-
Centers for Medicare and Medicaid Services
- CORF:
-
Comprehensive Outpatient Rehabilitation Facility
- DOQ-IT:
-
Doctor’s Office Quality-Information Technology
- EMCRO:
-
Experimental Medical Care Review Organizations
- EHR:
-
Electronic Health Record
- EMTALA:
-
Emergency Medical Treatment and Labor Act
- FY:
-
Fiscal Year
- HCFA:
-
Health Care Financing Organization
- HCQII:
-
Health Care Quality Improvement Initiative
- HCQIP:
-
Health Care Quality Improvement Program
- HHS:
-
Health and Human Services
- INTERACT:
-
Interventions to Reduce Acute Care Transfers
- IOM:
-
Institute of Medicine
- JAMA:
-
Journal of the American Medical Association
- LAN:
-
Learning and Action Network
- LANE:
-
Local Area Networks for Excellence
- NCQA-GMAP:
-
National Committee Quality Assurance – Geriatric Measurement Advisory Panel
- OPPS:
-
Outpatient Prospective Payment System
- PLN:
-
Physician Leadership Network
- PPACA:
-
Patient Protection and Affordable Care Act
- PQRS:
-
Physician Quality Reporting System
- PRO:
-
Peer Review Organization
- PSPC:
-
Patient Safety and Clinical Pharmacy Services Collaborative
- PSRO:
-
Professional Standards Review Organization
- QA:
-
Quality Assurance
- QAPI:
-
Quality Assurance and Performance Improvement
- QI:
-
Quality Improvement
- QIN:
-
Quality Innovation Network
- QIO:
-
Quality Improvement Organization
- RFP:
-
Request for Proposals
- SOW:
-
Scope of Work or Statement of Work
References
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FedBIZ QIN-QIO RFP. Available from: https://www.fbo.gov/index?s=opportunity&mode=form&id=dff522bababb6b9859bb783c08db6074
Title XI Social Security Act, section 1154. Available from: http://www.ssa.gov/OP_Home/ssact/title11/1154.htm
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QIO 10th SOW fact sheet. Available from: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityImprovementOrgs/Downloads/QIOOverview.pdf
The Patient Protection and Affordable Care Act. Available from: http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf
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Advancing Excellence quality website. Available from: http://www.nhqualitycampaign.org/files/Reducing_Inappropriate_Use_of_Antipsychotics_in_Nursing_Homes_part_2.pdf.slide 25 of 55
Advancing Excellence LANE. Available from: http://www.nhqualitycampaign.org/star_index.aspx?controls=lanes
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HHS National Action Plan for Adverse Drug Event Prevention. Available from: https://www.federalregister.gov/articles/2013/09/04/2013-21434/solicitation-of-written-comments-on-draft-national-action-plan-for-adverse-drug-event-prevention
AHQA PLN webinar series website. Available from: http://www.ahqa.org/quality-improvement-organizations/physician-leadership-network
Acknowledgment
The authors are grateful to Centers for Medicare and Medicaid Services staff who reviewed the manuscript.
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Disclaimer
The analyses upon which this publication is based were performed under Contract Number HHSM-500-2011-GA10C, entitled CMS10thSOW sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare and Medicaid Services, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore required no special funding on the part of this contractor. Feedback to the author concerning the issues presented is welcomed.
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Mims, A.D., Pederson, J.C., Gold, J.A. (2015). Healthcare Changes and the Affordable Care Act: A Physician Call to Action Quality Improvement Organizations. In: Powers, J. (eds) Healthcare Changes and the Affordable Care Act. Springer, Cham. https://doi.org/10.1007/978-3-319-09510-3_2
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DOI: https://doi.org/10.1007/978-3-319-09510-3_2
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