SSM Health Care clinical collaboratives: improving the value of patient care in a health care system.
BACKGROUND
In 1998 SSM Health Care (St Louis) began a series of clinical collaboratives modeled after The Institute of Healthcare Improvement (Boston) Breakthrough Series. There are now four collaboratives, with 46 teams in progress, and four additional collaboratives are scheduled.
Each collaborative consists of three phases: the prework, active, and the continuous improvement phases. The structure of the collaboratives is quite similar to that of the Institute for Healthcare Improvement Breakthrough Series. However, the SSMHC collaboratives include a continuous improvement phase, which was designed to help maintain gains from the projects and to involve entities not originally involved in the collaborative. RESULTS OF COLLABORATIVES IN PROGRESS: Entity teams participating in multiple collaboratives seem to ascend a learning curve and become progressively more skilled in subsequent collaborative work. In Collaborative 1--Improving the Secondary Prevention of Ischemic Heart Disease--the participating entities showed significant improvement in cholesterol screening and treatment. In Collaborative 2--Improving Prescribing Practices--the collaborative teams also showed significant improvement, with a combined cost savings of approximately $450,000 per year. Collaboratives 3--Using Patient Information to Improve Care and Assure Success-and-4--Enhancing Patient Safety Through Safe Systems--are under way.


CONCLUSIONS
The collaboratives accelerate improvement work through sharing of successes and failures and peer influence within a reinforcing environment. Most of the collaborative teams have reached their project goals, and the pace of clinical improvement work has accelerated since the start of the collaboratives. The collaboratives provide an environment for clinicians to constructively participate in improvement of patient care.
Kosseff
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SSM Health Care, 477 North Lindbergh Blvd, St Louis, MO 63141, USA.
Niemeier
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D003299:Cooperative Behavior; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D016519:Hospitals, Religious / Q000592:standards*; D006801:Humans; D007087:Illinois; D008923:Missouri; D009825:Oklahoma; D005791:Patient Care / Q000592:standards*; D011315:Preventive Medicine / Q000706:statistics & numerical data; D017749:Total Quality Management / Q000379:methods*; D014922:Wisconsin