Clinical Communities at Johns Hopkins Medicine: An Emerging Approach to Quality Improvement.
BACKGROUND
Clinical communities are an emerging approach to quality improvement (QI) to which several large-scale projects have attributed some success. In 2011 the Armstrong Institute for Patient Safety and Quality established clinical communities as a core strategy to connect frontline providers from six different hospitals to improve quality of care, patient safety, and value across the health system. CLINICAL COMMUNITIES: Fourteen clinical communities that presented great opportunity for improvement were established. A community could focus on a clinical area, a patient population, a group, a process, a safety-related issue, or nearly any health care issue. The collaborative spirit of the communities embraced interdisciplinary membership and representation from each hospital in each community. Communities engaged in team-building activities and facilitated discussions, met monthly, and were encouraged to meet in person to develop relationships and build trust. After a community was established, patients and families were invited to join and share their perspectives and experiences. ENABLING STRUCTURES: The clinical community structure provided clinicians access to resources, such as technical experts and safety and QI researchers, that were not easily otherwise accessible or available. Communities convened clinicians from each hospital to consider safety problems and their resolution and share learning with workplace peers and local unit safety teams.


CONCLUSIONS
The clinical communities engaged 195 clinicians from across the health system in QI projects and peer learning. Challenges included limited financial support and time for clinicians, timely access to data, limited resources from the health system, and not enough time with improvement experts.
Clinical Communities, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, USA.
Lois J
LJ
Gould
Patricia A
PA
Wachter
Hanan
H
Aboumatar
Renee J
RJ
Blanding
Daniel J
DJ
Brotman
Janine
J
Bullard
Maureen M
MM
Gilmore
Sherita Hill
SH
Golden
Eric
E
Howell
Lisa
L
Ishii
K H Ken
KH
Lee
Martin G
MG
Paul
Leo C
LC
Rotello
Andrew J
AJ
Satin
Elizabeth C
EC
Wick
Laura
L
Winner
Michael E
ME
Zenilman
Peter J
PJ
Pronovost
D003299:Cooperative Behavior; D058016:Health Facility Administration; D006801:Humans; D007373:Interinstitutional Relations; D009936:Organizational Innovation; D009937:Organizational Objectives; D061214:Patient Safety; D017064:Process Assessment, Health Care; D058996:Quality Improvement; D014481:United States