Connecting the Dots: Linking Clinical Quality Improvement, Maintenance of Certification, and Research

1. Connecting the DotsCreating a learning health system linking clinical quality improvement, Maintenance of Certification, and research Maureen Smith, MD, MPH, PhD Professor, Departments of Population Health Sciences, Surgery, and Family Medicine University of Wisconsin - Madison

2. Objective • Support clinicians conducting MOC Part IV quality improvement projects in publishing their results • Learn about the peer-reviewed publishing process • Provide instrumental support (templates, formatting) Additional Benefits • Extend traditional QI work to scholarly contributions • Leverage existing academic strengths in health services research • Build a foundation for future partnerships to support a learning health system

3. UW HealthUniversity of Wisconsin - Madison • Academic health system • ~10,000 employees • ~1,350 physicians • 350 primary care providers • ~275,000 medically homed patients • UW Health locations • UW Hospital – 566 beds • American Family Children’s Hospital – 61 beds • Primary care & specialty clinics – 47 clinics • Access Community Health Centers • Outreach sites in 50+ communities

4. UW Health Partners Creating a Learning Health System Professional Education Carla Pugh, MD PhD Health Services Research Quality Improvement Maureen Smith, MD PhD Sally Kraft, MD

5. UW Health MOC Portfolio Program Physicians work with teams to implement standard best practices Physicians enroll in UW Health MOC projects Best practices endorsed as UW Health MOC projects Improvements in care discovered by front-line teams

6. Disseminating Success Beyond UW Successful QI project completed, meets UW Health QI standards, MOC Part IV awarded AAMC Learning Health System Award used to develop online resources to support faculty publishing QI projects.

7. Partnering with health services research Professional Education Health Services Research Quality Improvement www.hip.wisc.edu

8. Health Innovation Program (HIP) Goal To improve health care delivery and population health across the state of Wisconsin and the nation through conducting & disseminating health services research that partners UW faculty with Wisconsin healthcare organizations hip.wisc.edu

9. HIP Results Since its launch in 2006, HIP has: • Supported investigators in receiving over $48 million in federally funded grants • Over 250 publications • Projects have involved hundreds of healthcare organizations and nearly 500 faculty, staff, and community members

10. Building a HIP QI Publishing Resource • Overview of writing and publication process • Downloadable templates • Manuscript file with placeholders/prompts as guides • Cover letter • Sample tables and figures • Sample response letter to reviews • Lists of journals that publish QI work • Formatting resources • And other useful publishing information hip.wisc.edu/QI_Publish

11. IRB Research Decision Tool • Online self-service tool provided by Health Sciences IRB • Streamlines ability to get an exemption for QI work https://kb.wisc.edu/hsirbs/page.php?id=33386

12. QI Publishing Resource • Launched approximately 1 year ago • Registration required to view materials • 37 registrations to date • 40% are from outside of UW • Pages with materials have been viewed ~200 times • Registrants working on a wide variety of QI projects • IRB site used widely across UW hip.wisc.edu/QI_Publish

13. Partnership as a Foundation • Building successful partnerships takes years • Takes resources and committed leadership • Focus on projects where there is an alignment between all partners • Quality team focuses on organizational high priority improvement goals • Education staff draws on their expertise and experience • Researchers work in their areas of interest and on projects for which they have secured funding • Develop a portfolio of projects so the success of the partnership does not depend on a single project

14. Foundation for a Bigger ProjectAnalytics infrastructure for the UW Health ACO IDENTIFY High-risk patients Chronic conditions MANAGE Care & case management Transitions management IMPROVE Refine Target Scale Refocus ANALYZE Admissions Readmits ED visits Total cost Medicare Claims Data + Electronic Health Records Data visualizationfor costly events ~1000 pages ofreports monthly Evaluation ofnew interventions Risk scores for~30,000 patients