Great Plains Quality Innovation Network

Task Order 1 will utilize innovation, broad quality improvement initiatives and data-driven methodologies suitable for spread to achieve five broad aims that cover:

1. Improve Behavioral Health Outcomes, focusing on Decreased Opioid Misuse
2. Increase Patient Safety
3. Increase Chronic Disease Self-Management (Cardiac and Vascular Health, Diabetes, slowing and preventing End Stage Renal Disease)
4. Increase Quality of Care Transitions
5. Improve Nursing Home Quality

The quality improvement projects under this Task Order will focus on the following high priority Task Settings/Areas that will maximize impact on the healthcare system and value while aligning with CMS and Health and Human Services Departmental goals and priorities: 

• Task Area 1:  Long Term Care – Nursing Homes
• Task Area 2:  Community Coalitions
• Task Area 3:  Quality Improvement Initiatives

Long term care – nursing home work will require recruitment of over 80% of nursing homes and target those in highest need of quality improvement, specifically those with a lower star rating status using the latest available nursing home compare data.

The recruitment of community coalitions will be required to cover at least 65% of beneficiaries in the state and reside in specified groups of contiguous zip codes.  SDFMC committed to four coalitions and will coordinate efforts by engaging community stakeholders and providers across all care settings, including acute, post-acute, and long-term support services to focus on improvement efforts.

SDFMC has two full-time equivalents (FTEs) assigned to the Task Order that will provide expert healthcare quality improvement services to support quality improvement efforts for maximum impact to the healthcare system.  The two staff will also serve as quality improvement experts, facilitators, and change agents for healthcare transformation that will span across focus areas to improve rural, medically-underserved, health disparities, vulnerable populations, and customer experience.  This Task Order allows for great flexibility in approaches and methods of achieving those outcomes and also allows for the use of real-time data sources to enable the most responsive efforts possible. 

Quality improvement initiatives (QIIs) may arise from a variety of sources including, but not limited to, beneficiary complaints, healthcare facility identified needs, data trend analysis, surveys, or stakeholders.  A QII is a formal activity designed to support quality improvement that may relate to safety, healthcare, health, and value and may involve providers, practitioners, beneficiaries, and/or communities.

South Dakota Foundation for Medical Care (SDFMC) serves as a second-tier subcontractor to the Great Plains Quality Innovation Network (GPQIN) and Comagine Health (the prime contractor for the American Indian/Alaskan Native Healthcare Quality Initiative (AIHQI) contract.  The AIHQI is designed to help Indian Health Service (IHS) hospitals achieve large-scale health transformation and instill strong organizational systems and processes that serve as the foundation for providing high quality healthcare.  The target population serves those American Indians living on and around IHS reservations and serviced by the IHS managed hospitals.  The goals/objectives of the AIHQI are to:

1. Support, build, and/or redesign the IHS hospital infrastructure by solidifying the foundational structures and processes that will lead to high quality healthcare
2. Support front-line staff working within the IHS hospitals in work to achieve sustainable high quality, reliable, and safe care and related processes
3. Instill the principals of continuous quality improvement
4. Improve health outcomes
5. Develop a patient-centered approach to care

The Task Order is very broad in nature and allows for much autonomy by the contractor based upon facility needs.

• Assess and identify gaps in practice and policy
• Identify and implement current evidenced-based practices and recommend updates
• Develop hospital leadership core capabilities for hospital management and operations
• Develop hospital systems that exceed the CMS Survey and Certification Requirements
• Proactively engage patients and families to expand their role in decision making
• Work directly with front-line staff on clinical quality improvement
• Train staff on Quality Improvement Methodology that enables sustainment of quality improvement
• Generate and build systems for collection to analyze and utilize data to facilitate improvements
• Ensure data integrity across IHS/CMS electronic reporting systems
• Assess care team functions on skills, abilities, and credentials in support of efficient and effective delivery of care
• Collaborate with the hospital leadership to implement proven methods for creating a positive work environment
• Implement evidence-based practices in care coordination for high risk/utilization patients
• Develop methodology and address patient risk stratification
• Assist the hospital with development of information about community resources
• Collaborate with hospitals to assess and adjust the flow of patients and related activities for optimal efficiency
• Collaborate with hospitals to increase the appropriate utilization of healthcare resources
• Assist hospitals in utilizing existing telemedicine services to support localized care

SDFMC PATH partners serve as objective sources of technical assistance for the IHS hospitals on relevant quality improvement initiatives and facilitate knowledge transfer and dissemination of resources for hospital transformation.  The Community Engagement Advocate also plays a significant role in successful achievement in supporting the foundational structure and processes required for high quality healthcare.