Patient Safety and Quality

Quality partnerships yield advances in collaboration

Partnerships for Quality (PFQ) is a 2002 Agency for Healthcare Research and Quality (AHRQ) initiative focused on improving health care safety and quality. PFQ projects are collaborations among researchers, health plans, medical facilities, employers, consumers, and professional organizations and lead to documented changes that can be rapidly disseminated to and implemented by practices. AHRQ funded 22 PFQ cooperative agreements in 2002 that covered a range of topics, including patient falls, bioterrorism preparedness, and home care. In 2003, principal investigators (PIs) for 20 of the funded projects formed the AHRQ Council of Partners.

The work completed by the Council's subcommittees on implementation, the science of partnerships, dissemination, evaluation, and sustainability is highlighted in seven articles that appeared in the Volume 22, Number 12 supplement to the Joint Commission Journal of Quality and Patient Safety published in December 2007. The papers are briefly summarized here.

Mullican, C. and Clancy C. "Partnerships for Quality: Result of the AHRQ Council of Partners co-action across projects," pp. 4-6.

In 2002, with the adoption of a new, action-focused mission statement to improve the quality, safety, effectiveness, and efficiency of health care for all Americans, AHRQ funded PFQ projects to better identify barriers to putting research findings into practice. Though the PFQ projects hit on different topics, they shared common threads and their PIs were expected to participate in grantee meetings twice a year to explore possibilities for collaboration. This article provides an overview of how the PFQs were established to better translate research into practice.

Savitz, L.A. "Managing effective participatory research partnerships," pp. 7-15. (AHRQ grant HS13706)

Using experiences from the partnership science subcommittee, this article gives tools for managing organizational-based participatory research partnerships. These alliances share resources to advance a common purpose. The author presents basic tenets of research partnerships, including collaborative circles, social capital, modes of belonging, and partnership synergy. These concepts permit an understanding of the factors contributing to successful research partnerships. RTI International's Integrated Delivery System Research Network is described as an example of a research partnership that offers its counterparts a wealth of lessons learned on the value of internal and external communication and periodic surveys.

Sharek, P., Mullican, C., Lavanderos, A., and others. "Best practice implementation: Lessons learned from 20 partnerships," pp. 16-26.

This article explores barriers to partnerships and solutions to resolve those barriers. After surveying PIs from the 20 PFQ organizations, the top 4 barriers were categorized as partnership challenges (difficulties developing or maintaining a partnership), practitioner and local organization variables (difficulties engaging physicians at the local level or barriers in the local practice environment), timeframe challenges (difficulties developing the partnership within a timeframe to keep up momentum), and financial concerns (difficulties getting local funding). A second survey explored how PIs countered challenges. The successful (98) and unsuccessful (33) interventions were recorded, and many of the interventions in both categories centered on communication strategies.

Single reprint copies (Publication No. AHRQ 08-R038) are available from the AHRQ Publications Clearinghouse.

Donaldson, N., Horn, S., Edwards, J., and others. "Evaluating the impact of partnerships to improve clinical quality," pp. 27-36.

This article summarizes the ability of PFQ's Evaluation Framework and Tool to assess the impact of partnerships and their effect on translating research into practice. The customizable tool asks investigators to consider their project methods, processes, and products. Products can be considered as having impacts on four different levels: the knowledge base or future research, policies and procedures, clinical practice, and health outcomes. The goal of addressing these impacts is to ensure none are overlooked and to view them from the vantage point of those who will either fund or implement products to improve health care.

Single reprint copies (Publication No. AHRQ 08-R039) are available from the AHRQ Publications Clearinghouse.

Edwards, J., Feldman, P., Sangl, J., and others. "Sustainability of partnership projects: A conceptual framework and checklist," pp. 37-47.

Reporting on the work of the AHRQ Council of Partners' sustainability subcommittee, the authors explain the steps planners must take to ensure a project endures, such as defining what it means for a project to continue and the elements needed for it to do so. Elements identified to assist in sustainability include infrastructure (people, technical, and financial resources), incentives, opportunities for participation, and integration. The subcommittee developed a checklist for partnership leaders to consider sustainability during project design so it would not be an afterthought.

Single reprint copies (Publication No. AHRQ 08-R040) are available from the AHRQ Publications Clearinghouse.

Boratgis, G., Broderick, S., Callahan, M., and others. "Disseminating QI interventions," pp. 48-65.

This article presents three partnership case studies that were selected using the PFQ Dissemination Planning Tool. The tool, created by the AHRQ Council of Partners' dissemination and impact subcommittee, provides a systematic method for researchers from different backgrounds to plan the dissemination portion of their projects. Commonalities among three quality improvement partnerships were explored to mine information on why they were successful: Catholic Healthcare Partners Heart Failure Partnership, the Center for Value Purchasing, and the New York State Information Dissemination project. The RE-AIM model (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) was used to assess the role partnerships played in the three partnerships' successes in dissemination and impact.

Single reprint copies (Publication No. AHRQ 08-R041) are available from the AHRQ Publications Clearinghouse.

Lannon, C., Dolins, J., Lazorick, S., and others. "Partnerships for Quality Project: Closing the gap in care of children with ADHD," pp. 66-74. (AHRQ grant HS13721)

One of the Partnerships for Quality projects addressed closing the gap between knowledge and care for children diagnosed with attention-deficit hyperactivity disorder (ADHD). The American Academy of Pediatrics, the American Board of Pediatrics, Children and Adults with Attention Deficit/Hyperactivity Disorder (an advocacy organization), and the Center for Health Care Quality came together as partners to improve care for children with ADHD. The project collaborators used workshops, online modules, technical assistance from the project team, routine call-in meetings, and dissemination plans to advance their goal. Participation resulted in improved care outcomes and involvement in quality improvement activities.

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