Appendix B: Summaries
of PFQ Grantee Activities
Important Note: Content for
grant summaries was drawn from a variety of sources, including: 1) grantee
proposals, progress reports, and other grant-related documents; 2) information
obtained in interviews with grant principal investigators and project partners,
3) updates on progress, outcomes, findings, and products provided by grant
project leaders. Where grantee-produced documents clearly stated goals,
activities, or outcomes, we used that text for the summaries. All grantee PIs
or their staff had an opportunity to review the drafts of these summaries, and
modify the text to ensure that it described their projects accurately.
Contents
Altarum Institute
American
Academy of
Pediatrics
American College of Physicians
American Hospital Association (AHA), Health Research and Educational
Trust
American Medical Association
American Medical Directors Association
Foundation
Association of
California Nurse Leaders and California Nursing Outcomes
Coalition
Catholic Healthcare Partners
Child Health Corporation of America
Connecticut Department of Public Health (DPH)
HealthFront
International Severity Information Systems, Inc.
Joint Commission on Accreditation of Healthcare Organizations
The Leapfrog Group
Lehigh Valley Hospital and Health
Network
New
York State Department of
Health
Physician Micro Systems, Inc.
Research Triangle
Institute
Texas A&M University System
Visiting Nurse Service of New York
PFQ Grant Summary: Improving Health Care Responses to Bioterrorist Events
Lead Organization: Altarum Institute
Partner Team: Altarum Institute, Michigan Center for Biological Information (MCBI),
University of Michigan Department of Emergency Medicine; Texas
Community Emergency Health Care Initiative (CEHI), University of
Texas Health Science Center, Texas A&M University, US Army
Medical Department Board, National Pharmaceutical Stockpile of the
Centers for Disease Control and Prevention, various organizations within
the two target communities.
Title: Improving Health Care Responses to Bioterrorist Events
Topic Area: Bioterrorism and emergency preparedness
Principal Investigators: George Miller, PhD
AHRQ Project Officer: Sally Phillips
Total Cumulative Award: $397,835
Funding Period: 9/2002–9/2006
Project Status: Completed 9/29/2006
1. Project
Description
Goals. The project planned to employ the Healthcare Complex Model (HCM), a
simulation modeling tool, to plan for the care that victims would need from the
acute medical delivery system following a bioterrorist attack. The project
proposed testing the utility and validity of HCM in supporting bioterrorism
readiness planning in both a rural and an urban health care network by
estimating the demand for care by medical facilities.
Project
goals expanded to include the development of another model, the casualty prediction
model (CPM), which, using alternative assumptions about the public health
response, would estimate the spread of disease following an attack. Both models
were intended to assist community efforts to plan for medical care and public
health responses, including such issues as staffing, supplies, and patient
flow, in the event of bioterrorism attacks or other emergency, such as
naturally occurring influenza outbreaks.
Activities and
Progress
Year
1. Work on the grant did not begin until March 2003, halfway through the
first project year, because of delays in AHRQ's release of funds to PFQ
grantees. The project convened a series of meetings with partners to discuss
HCM's capabilities and solicit their input on setting up and analyzing the
rural scenario in which to deploy HCM. The project decided to model pneumonic
plague for the first application and chose Smithville Hospital, a rural
hospital in Bastrop County, Texas, as the setting. The project obtained and
prepared population, clinical, and facility data (input data) for the rural
scenario through its partnership with the Texas CEHI and with the cooperation
of the Smithville Hospital staff.
The
project used the data to create several model cases that investigated
alternative response strategies for dealing with a plague outbreak. Such
responses included augmenting the existing medical infrastructure with
volunteers and state and federal assets, for example. The analysis of the
first application of HCM activity showed that, even in a rural setting with a
very small number of initially infected victims, early detection of an attack
and subsequent aggressive response could result both in saving a significant
number of lives and in significantly reducing the demand for scarce resources
needed to treat primary and secondary victims. The model and data that were
developed for the rural setting in phase 1 could be easily extended to address
issues of interest to planners in a specific community or to further general
planning for rural hospital preparedness.
The
HCM benefited from enhancements made in response to its use in the rural
scenario. In particular, the project developed the CPM to serve as an input to
the HCM and generate a patient/casualty stream that would impose demands on the
acute care system in the model. Enhancements to HCM, including the addition of
the CPM, were carried over to the second application of HCM in an urban setting
in the second project year.
Year
2. For the second application of HCM, the project chose the San Antonio, Texas, area as the urban setting in which to simulate a terrorist-produced
smallpox outbreak. It developed various options for the public health system to
use to reduce the number of victims and for the acute care system to use to
improve patient outcomes. The CPM and HCM were used to study several scenarios
designed to determine the effects of early and aggressive attempts to immunize
the population (mass vaccination) versus more deliberate and time-consuming
tracing and immunization (ring vaccination). The project sought to closely
integrate the functions of the CPM with those of the HCM so that they could
improve their representation of the interrelationship between public health activities
and the provision of acute care.
The
project presented to public health and hospital officials in the San Antonio
area what had been learned from the CPM model about the impacts of varying
public health responses to a smallpox attack (including alternative vaccination
programs, various actions to reduce the frequency of contacts between infective
and susceptible individuals, and isolation of infective victims) on the
magnitude of the patient stream arriving for treatment at medical facilities.
One finding suggested that a policy of mass vaccination results in many fewer
victims and a lower chance of an epidemic than does tracing and immunization
alone. The HCM modeled the daily number of victims presenting for medical
care, cumulative mortality, and demand for health care resources (e.g., demand
for ICU beds) after a smallpox outbreak, given varying public health response
measures. The model found that daily victims, mortality, and demand for
healthcare resources tended to be lowest with the use of a mixture of public
health measures rather than extensive use of a single measure. However, unless
the attack was very small, these measures were unlikely to prevent a surge in
demand for acute care that would require community-wide coordination of resources,
a definitive patient triage policy, and temporary treatment practices.
Year
3. Activities in the third project year included a quantitative
investigation of the benefits of improved surveillance on the ability to react
to a smallpox attack; an analysis of the use of quarantine in response to a
smallpox attack; and a validation study of the CPM. Early on, the project had
established a partnership with Texas A&M, another PFQ grantee that was also
doing bioterror work, and that partnership helped in gathering the input data
for the study. The results suggested that early detection and response reduced
the number of eventual victims, as mass vaccination reaches a larger percentage
of the population before exposure. They also confirmed that initiating smallpox
vaccination less than six days after the event had essentially no additional
benefit, but that pursuing detection and response early enough to benefit the
second generation of possible infections was necessary. In addition, the model
found that a voluntary quarantine program as an adjunct to a ring vaccination
program might dramatically decrease the total number of smallpox victims. The
project also validated the CPM by configuring it to represent influenza and
then showing it capable of producing values that are consistent with empirical
data collected during epidemiology studies of populations experiencing an
influenza outbreak.
Year
4. Since the project had already configured the CPM to represent influenza
for the validation study, the project decided to modify the CPM to allow
investigation of the impact of targeted vaccinations of public health workers
and other first responders in the event of an influenza outbreak. Texas A&M University again assisted the project by providing input data. Results from
the analysis showed the importance of establishing a sufficient level of
immunity in the first responder and health care worker subpopulations because
of their high risk of contact with infective victims. Immunity in these
subpopulations is important since the analysis showed that infection among them
will adversely affect the ability of the community to respond to the epidemic.
The project also cast doubt on the argument to establish immunity within these
subpopulations prior to the epidemic, principally since small numbers of first
responders and health care workers are involved. An ongoing effort involves
investigating the effectiveness of other specific strategies to combat an
influenza epidemic in San Antonio.
2. Partnership
Structure/Function
Many of the people
and organizations listed as partners in the project were consultants or
advisors, lending their subject expertise in the development of the models (see
table below). Communication between Altarum and these experts occurred as
needed, increasing in frequency when models were being refined. Other partners
listed, including CEHI, Texas A&M, and some of the target organizations,
were actively involved in obtaining the data necessary to run the various
simulations. Communication between Altarum and the two communities that served
as the simulation settings—San Antonio and rural Bastrop County near
Austin—were not regularly scheduled, but communication did increase while
project was gathering information. The project also scheduled seminars and
briefings in the San Antonio area to keep the community abreast of the
project's work.
Table 1. Major Partner Organizations and Roles in the Project
|
Organization |
Role in Project |
Lead Organization (grant recipient) |
The Altarum Institute
|
Led the project, providing
knowledge and expertise based on the company's history working with advanced
informatics systems solutions and knowledge tools
|
Key
Collaborators |
Texas Community Emergency
|
Helped to identify the setting and
obtain input Healthcare Initiative (CEHI) data for the rural scenario to be
used in HCM
Served as a
functional expert in reviewing model output
|
Texas A&M University
|
Provided input data for the
influenza model and the representation of
surveillance in the third and fourth project years
|
Consultants:
Michigan Center for Biological
Information (MCBI)
University of Michigan Medical Center
Department of Emergency Medicine
University of Texas (UT) Health
Science Center
U.S. Army Medical Department Board
Centers for Disease Control and
Prevention, National Pharmaceutical
Stockpile
|
MCBI served as functional expert on
bioinformatics, biological warfare, and
terrorism
University of Michigan served as functional
experts in selecting the diseases to be
investigated, identifying needed data, reviewing
results for validity, and inferring useful
observations
UT provided subject matter expertise to help
develop the models and validate the models'
assumptions; also provided public health
contacts in the community
The Army Medical Department Board reviewed
results and assisted with other contacts within
the Department of Defense medical community
Representatives of the National Pharmaceutical
Stockpile provided a critique of the HCM
|
Target Organizations |
Two Communities:
San Antonio—including
representatives of Region 8 of the
Texas Dept. of State Health
Services, San Antonio
Metropolitan Health District,
Greater San Antonio Hospital
Council, Southwest Texas
Regional Advisory Council,
Brooke Army Medical Center, and
Wilford Hall Medical Center
Smithville Hospital in Bastrop
County, TX (near Austin)
|
Provided settings and assisted in identifying
associated data and assumptions for model
simulations
|
3. Project Evaluation and Outcomes/Results
Altarum had been working with the HCM model prior to
the AHRQ grant, using it for simulations in other contexts, including flow of
patients in health systems, facilities planning, staffing, and telemedicine.
The PFQ grant provided Altarum with an opportunity to continue this work and to
test its utility for other simulation exercises.
The project successfully used its two models to
provide information for bioterrorism planning in public health and in health
care systems at the community level. One piece of information provided to the
public health system in San Antonio was especially useful—that vaccinating
40,000 people a day (rather than the 270,000 the system had intended) in the
event of a smallpox outbreak would be enough to control the epidemic.
According to one respondent, this information helped the public health
authority in San Antonio determine the number of vaccine distribution sites
needed, and the correct number of sites is now in its plans. Other information
provided by the smallpox simulation changed the public health authority's
purchasing strategy for bioterror preparedness supplies. The authority decided
to prioritize buying certain supplies (e.g., ventilators, isolations rooms,
etc.) in hospitals and coordinated and standardized the equipment purchased at
those hospitals. Beyond these two examples, it is unclear how much the
communities that served as the locations for the simulations used the
information from the study to make other practice or policy changes. However,
the models and data that were developed for both the rural and urban settings
can be extended to address issues of interest to planners in a specific
community or to further planning for hospital and public health system
preparedness. The project also validated the use of CPM for other disease
outbreaks.
4. Major Products
- Miller, G., S. Randolph, and D. Gower. "Simulating the Response of a Rural Acute Health-Care Delivery
System to a Bioterrorist Attack." International Journal of Disaster Medicine,
vol. 2, 2004, pp. 24-32.
- Miller, G., S. Randolph, and J.E. Patterson. "Responding to Bioterrorist Smallpox in San Antonio." To
appear in Interfaces, November-December 2006.
- Testimony at a
Joint Meeting of the Senate Judiciary and House Veterans Affairs/Homeland
Security Committees of the Michigan Legislature, October 2003.
- Presentations to
the University of Texas Health Science Center, December 2003 and January 2005.
- Seminar at Case Western Reserve University, March 2004.
- Presentations at
national meetings of the Institute for Operations Research and the Management
Sciences, October 2004 and November 2005.
- "Modeling Public
Health and Medical Treatment Responses to Smallpox and Influenza Outbreaks."
Paper presented at the San Antonio and Austin Life Sciences Association
Biodefense Summit, April 21, 2006.
- "Responding to
Bioterrorist Smallpox in San Antonio." Paper presented as part of the
Colloquium Series of the Management Science and Statistics Department, College of Business, University of Texas at San Antonio, April 25, 2006.
- Presentation at
the U.S. Army Force Health Protection Conference, August 2006.
5. Potential for Sustainability/Expansion after PFQ
Grant Ends
After the grant ends, Altarum will continue working
with both the HCM and CPM. The principal investigator hopes eventually to use
the models to study a health system network representation of the spread of
disease. The project's most recent work under the grant on targeted
vaccinations is a step in this direction. Though the San Antonio community
expressed interest, it has not committed any funds to continue the modeling
work. Altarum believes that the U.S. Department of Defense (DoD), which has
more resources to devote to planning for community disaster assistance, is a
more likely source of funding for follow-up work, and it has initiated
discussions with DoD agencies.
Return to Appendix B Contents
PFQ Grant Summary:
Partnership to Improve Children's Health Care Quality
Lead Organization: American Academy of Pediatrics (AAP)/ Center for Health Care Quality
at Cincinnati Children's Hospital Medical Center (CCHMC) [Note:
Grant shifted from the National Initiative for Children's Healthcare
Quality (NICHQ) to AAP in June 2004.]
Partner Team: AAP and CCHMC with an advisory board comprising American Board
of Pediatrics (ABP), Children and Adults with Attention Deficit Disorder
(CHADD), etc.; also 10 AAP state chapters and 186 local pediatric
practices.
Title: Partnership to Improve Children's Health Care Quality
Topic Area: Improve care for children with attention deficit hyperactivity disorder
(ADHD)
Principal Investigators: Dr. Carole Lannon, MD, MPH, Center for Health Care Quality, CCHMC
AHRQ Project Officer: Charlotte Mullican
Total Cumulative Award: $1,298,266
Funding Period: 9/2002–9/2006
Project Status: Completed 9/29/2006
1. Project
Description
Goals. This project sought to improve care for children with ADHD by teaching
physicians to use an interactive web-based Continuing Medical Education (CME)
quality improvement tool called Education in Quality Improvement for Pediatric
Practice (eQIPP). It did so drawing on the combined resources of a partnership
among the CCHMC, AAP, ABP, and an advisory board of experts and related
organizations, as well as state AAP chapters and pediatric practices. The
project was designed to 1) improve pediatricians' adherence to evidence-based
care guidelines for children with ADHD through a training program that taught
physicians to measure their processes of care with an on-line tool; and 2)
develop the capacity of local chapters of professional medical organizations to
support members' improvement activities. AAP also wanted to gain recognition of
this measurement-based CME program as qualifying for new ABP "maintenance of
certification" requirements. If successful, the model would be used to address
other health issues of children. Finally, the participating organizations
hoped to learn more about the use of professional organizations to facilitate
improvement at the practice level.
Activities
and Progress. Year 1 of the project was spent on planning and development
activities. Project staff established an advisory board, recruited and selected
AAP chapters to participate in the first year of the intervention, finalized an
evaluation plan and measures of success, and developed recruitment and training
materials for AAP chapters and practices.
Prior
to receiving the PFQ grant, the AAP developed an ADHD eQIPP module. An
interactive tool for pediatricians that is available on-line eQIPP incorporates
specific content education and teaches QI principles as applied to the content
area. For this project, eQIPP helps physicians to assess their practices by
having them answer 5-10 questions based on a review of at least 10 patient
charts, and then provides feedback that allows them to evaluate their
performance against relevant comparison measures and benchmarks. Physicians
using eQIPP get CME credit and opportunities to track progress and monitor
changes in practice over time.
In
year 2, the project team (AAP/CCHMC) began technical assistance and ongoing
support to the four selected AAP chapters. (Initially, the project team
selected five AAP chapters but one chapter deferred participation until the
following year.) Each selected chapter was given $13,000 to use for additional
staff, program costs, or other infrastructure needs. AAP chapters were
responsible for recruiting pediatric practices to participate in this project.
Once the practices agreed to participate, the AAP chapters helped them to
enroll in eQIPP and work through the ADHD module to complete a "prework"
assignment prior to a six-hour training workshop held by their AAP chapter.
The participating practices used eQIPP to collect baseline performance
measurements on their care for children with ADHD.
At
the training workshop, the participants learned to 1) apply key change concepts
in caring for children with ADHD; 2) identify essential components of a staged
implementation plan for providing optimal care for this chronic condition; 3)
plan strategies for difficult cases; 4) develop partnerships with parents,
educators, and behavioral health providers and community groups; and 5) provide
education and support for parents and families. The AAP/CCHMC project team
provided guidance for each chapter's workshop preparation and led the quality
improvement and measurement sessions at each workshop.
In
year 3, the project team recruited an additional five AAP chapters and began
the same series of training work with them (as well as with the chapter from
year 2 that deferred participation). The project team also continued technical
assistance to the original four AAP chapters and participating practices. In
August 2005, the project held a one-day conference for AAP chapter presidents,
just prior to the AAP Annual Leadership Forum, to highlight and share what
chapters had learned about initiating local improvement efforts and supporting
practices to improve care.
In
year 4, the project team focused on completing the ADHD improvement efforts
with the 10 AAP chapters. The team also refined its plans for evaluation and
completed data collection efforts. In August 2006, the project team held a
chapter leader workshop, bringing together 18 chapter teams, composed of AAP
chapter leadership (executive director and physician champion) as well as local
public health agency partners (such as state maternal and child health
departments or Medicaid directors), in order to share lessons on how to build
interest in QI, integrate QI into CME programs, and support the QI change
process in practices. Public health agencies were invited because project
directors believe that chapters were most successful in sustaining activities
following the initial workshop when they partnered with such organizations.
2. Partnership
Structure/Function
The
principal investigator (PI) is located at CCHMC, although the grantee is the
AAP.1 The two organizations jointly comprise the core project team
and together manage the project. They hold monthly conference calls and have
worked as partners to coach the AAP chapters to recruit practice teams, prepare
practice teams for the improvement workshops, plan and conduct the workshops,
manage eQIPP enrollment and data collection, and support the development of the
chapters' improvement infrastructure.
The
CCHMC-AAP project team was divided into three subgroups: 1) improvement
partnerships, to develop an ongoing improvement infrastructure and support AAP
chapters in sustaining improvement work after the PFQ project, 2) curriculum
development, to assess the ADHD workshop curriculum and review the ADHD toolkit
and eQIPP modules, and 3) evaluation, to develop the measurement strategy, data
collection tools, and workshop evaluations as well as to collect and compile
monthly data from the chapters and eQIPP data from the practices. Monthly
conference calls are held between the advisory board and project team
subgroups.
Monthly conference calls are also held between the
CCHMC-AAP project team and the AAP chapters. These calls serve to coach chapter
leaders in the recruitment of practices, help pediatricians with preworkshop
preparation, plan the workshops, and coordinate with expert faculty.
Regular calls take place between the CCHMC-AAP project
team, the AAP chapters, and the participating practices. For example, the
CCHMC-AAP project team held calls in early 2006 to discuss topics of interest
to the practices, such as CHAAD parent-to-parent training and mimickers of
ADHD. In addition, the project team, chapters, and practices communicate with
each other via the project's electronic listserv. Weekly, the CCHMC-AAP project
team send a case study to the listserv and practices respond, ask questions,
and/or share their experiences.
Table 1. Major Partner Organizations and Roles in the Project
|
Organization |
Role in Project |
Lead Organization (grant recipient) |
American Academy of Pediatrics
(AAP)/Center for Health Care Quality,
Cincinnati Children's Hospital Medical
Center (CCHMC) [Note: Original grant
recipient was the National Initiative for
Children's Healthcare Quality (NICHQ),
but this shifted to AAP in 2004. The PI
is based at CCHMC.]
|
Provides overall leadership; coordinates
communication between partner sites, and
manages the project timeline
Coaches the AAP chapters to recruit practice
teams, prepares practice teams for the
improvement workshops, plans/conducts the
workshops, manages eQIPP enrollment and
data collection, and supports the development
of the chapters' improvement infrastructure
|
Key
Collaborators |
Advisory board [Members include: AAP,
American Board of Pediatrics (ABP),
Children and Adults with Attention
Deficit Disorder (CHADD), and the
American Board of Medical Specialties
(ABMS)] |
Provides counsel regarding challenges with
implementation and facilitating communication,
of project activities through various partnership
channels
|
Target Organizations |
10 AAP state chapters (yr. 2: IN, MS,
NM, VA; yr. 3: CT [deferred from yr. 2],
FL, MD, OK, UT, WV)
186 pediatric care practices in the 10
states with participating AAP chapters
|
Recruit primary care practices to participate in
project; organize and sponsor training
workshops; offer technical assistance and
training to practices Attend workshop, implement practice changes,
and collect/report data using eQIPP
|
3. Project Evaluation and Outcomes/Results
The evaluation will address three major research
questions: 1) Does the frequency and participation in improvement activities
differ between practices enrolled in eQIPP alone and those enrolled in eQIPP
with an AAP chapter support program? 2) Will appropriate disease management
for ADHD improve across time for the treatment group? 3) What factors
contribute to or inhibit a chapter's ability to improve and to sustain
improvement?
The evaluation will not assess the impact of the
program on patient outcomes because the link between the improved process of
care delivery to children and better outcomes for children with ADHD has
already been established.
As of March 31, 2006, 115 individuals had entered 1304
chart reviews (612 from year 2 and 692 from year 3) into unit 1 of the eQIPP
program as part of the prework for the AAP chapter workshop. Final aggregate
reports are being prepared. These reports will show the proportion of charts
demonstrating the target level of care for the seven components of diagnosis
and treatment for ADHD by all participating practices and by participating
practices in each chapter. A manuscript describing the findings based on this
data is in progress (listed under publications).
As of March 31, 2006, 45 individuals had entered
follow-up data from 498 chart reviews (299 from year 2 and 199 from year 3)
into unit 4 of the eQIPP program. Final aggregate reports showing follow-up
data will be provided to the chapter teams that reached the 50-chart minimum
instituted by the AAP.
Interviews have been conducted with team members from
all 10 participating chapters. The interview data will be used in the overall
evaluation to measure progress toward project aims and will also help the AAP
in planning future chapter supports for quality improvement efforts. A
manuscript describing the results of the interviews is in progress (listed
under publications). Interviews of AAP leaders will also be conducted in the
final year of the program.
All participating physicians were surveyed about their
experiences with the project and the eQIPP program. The survey was initially
distributed electronically and then followed up with two mailings. Analysis of
responses is under way.
4. Major Products
- Resource toolkit
(more than 75 pages), based on evaluation results for AAP chapter leaders,
containing guidance on getting started and making presentations, as well as
information on basic QI methods, successful improvement activities from AAP
chapters, and workshop materials (currently in development). Two copies of each
toolkit will be provided to each chapter. In addition, the guide will be
available on the AAP's Web site and updated regularly.
- Team members led
a workshop, "From National to Local Improvement: A Multi-Faceted Intervention
to Improve Care for Children with ADHD" at the NICHQ 5th Annual
Forum for Improving Children's Healthcare in Orlando, FL, in March 2006.
- Two posters were
presented at the Pediatric Academic Societies Annual Meeting in San Francisco,
CA, in April, 2006: "Partnership for Quality: Structured Support
to Improve Care for Children with ADHD" and "Measuring Performance in Practice
for the Care of Children with ADHD."
- An article
entitled "Chapter-Based Collaborations Improving Care for Children" will be
published in the AAP News in June 2005.
- At least four
manuscripts are anticipated:
- Lazorick,
Suzanne, Virginia L.H. Crowe, Judith C. Dolins, and Carole M. Lannon. "All
Improvement is Local: Evaluating the Use of an Innovative, Multi-Faceted
Intervention by a National Professional Organization to Translate its
Guidelines into Practice." Based on poster sessions at the Academy Health
Annual Research Meeting and Child Health interest group, Boston, MA, June 27, 2005 and the NRSA Fellows meeting, Boston, MA, June 28, 2005; and a
presentation at the AHRQ Translating Research Into Practice meeting, Washington DC, July 17, 2005.
- Lannon, Carole M., Suzanne Lazorick, Judith
Dolins, and Thaddeus Anderson. "Measuring Performance in Practice for the Care
of Children with ADHD."
- Lannon, Carole, Judy Dolins, Suzanne
Lazorick, and Virginia L.H. Crowe. (manuscript in preparation for journal supplement, Joint
Commission Journal on Quality and Safety, spring 2007).
- Manuscript on practice changes in disease management as a result of
participation in PFQ.
- Dr. Lannon
discussed the PFQ project at three workshops at the AAP SuperCME meeting in Orlando, FL, April 29-30, 2004. In addition, Dr. Lannon outlined how the PFQ project can
help residency-training programs meet the requirements of the ACGME
competencies at the Association of Pediatric Program Directors meeting and at
the Continuity Clinic Special Interest Group at the Ambulatory Pediatric
Association.
- Dr. Lannon used
multiple examples from PFQ in presentations to the AAP Annual Leadership Forum
in August 2004 and the AAP Board of Directors, October 2004.
- At the AAP
National Conference and Exhibition, November 1-5, 2003, Dr. Lannon presented a
workshop: "Think Globally, Act Locally: Working with Chapters to Improve
Quality of Care."
5. Potential for Sustainability/Expansion after PFQ
Grant Ends
It is likely that this program will continue after the
end of the grant. AAP has hired a full-time staff person whose responsibility
is to continue working with the state chapters on quality improvement
initiatives. Plans are under way to develop additional eQIPP modules. At the
August 2006 meeting, planning for an ongoing learning network for chapters was
begun.
Also, the AAP chapters participating in PFQ have
continued and expanded work begun in the PFQ project. Three of these chapters
are continuing with the ADHD project and four have formed new partnerships to
improve care for children with ADHD. Six chapters have gone on to design or
implement other quality improvement projects. Three of these have secured
additional funding and five have developed new partnerships to conduct quality
improvement projects. As a result of participation in the PFQ project, six
chapters have made other specific changes to promote a quality improvement
focus. For example, the New Mexico AAP chapter received other grant funds to
develop a quality improvement program focusing on obesity prevention, in
partnership with the University of New Mexico's Department of Pediatrics and
the New Mexico Human Services Department.
1. The PFQ grant was
originally awarded to the National Initiative for Children's Healthcare Quality
(NICHQ), but shifted to the American Academy of Pediatrics in 2004, when the
PI's center left that organization. The PI is currently located at CCHMC.
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