# Presentation: 534980

## HRSA Health Disparities Collaboratives 2006

**Ahmed Calvo, M.D., M.P.H., FAAFP**
**U.S. Department of Health and Human Services**
**Health Resources and Services Administration**
**Bureau of Primary Health Care**
**Division of Clinical Quality**

## Care South Carolina Community Health Center

## Most Frequent Diagnoses in Health Center Encounters, 1998–2004Alcohol and drug abuse, along with other mental health disorders take over as most prevalent encounter diagnoses

## Quality Improvement: Quick History of Health Centers (HCs) in the HRSA HDC Program

| 1998 | 2006  |
| --- | --- |
| 5 HCs |   ~850 HCs Nationally
  >90% of HCs in HDC 
  1,100 teams to date |
| EXCELLENT OUTCOMES |  |
|   Institute for Healthcare     
   Improvement
  Don Berwick, M.D.,   
   Boston |  |

## What Is a Collaborative?

- A collaborative is an intensive, concentrated effort to facilitate breakthrough transformations in the clinical and operational performance of clinical teams and their organizations, based on what already works.
- The entire effort is an evidence-based approach using ideas that are known to work effectively at the clinical sites and in the management information systems.

## Why Is the Collaborative Designed in This Manner?

- Science of system – change designed to:
- Define, document, and disseminate ideas
- Accelerate improvement and achieve results
- Build clinical leaders and systems of change
- Based on the Institute of Medicine (IOM) definition of quality of care involving six distinct dimensions

## Six Aims of HDC Quality Improvement: STEEEP Climb to Higher Ground

- S – Safe
- T – Timely
- E – Effective
- E – Efficient
- E – Equitable
- P – Patient Centered
- Reference: Institute of Medicine – *Crossing the Quality Chasm: A New Health System for the 21**st** Century *(2001)

- HRSA Health Disparities Collaboratives

- Patient self-management support
- Delivery system designed for patient support
- Evidence-based decision support
- Clinical information system to monitor outcomes
- Organization of health care for quality
- Community partnerships

**The ****Planned Care Model**** ****includes six essential elements for improving the care of people (organized for more team function and increased 21****st****-century electronic information exchange and entire team access to information): **

## Collaborative Engine

**Infrastructure Support**
-  Web site   E-mail   Visits   Phone   Assessments   Web-ex

## GOAL 1: Improve access to health care
GOAL 2: Improve health outcomes
GOAL 3: Improve the quality of health care
GOAL 4: Eliminate health disparities
GOAL 5: Improve the public health and health care systems
GOAL 6: Enhance the ability of the health care system to respond to public health emergencies
GOAL 7: Achieve excellence in management practices

- GOAL 2: Improve health outcomes
- GOAL 3: Improve the quality of health care
- GOAL 4: Eliminate health disparities
- GOAL 5: Improve the public health and health care systems
- GOAL 6: Enhance the ability of the health care system to respond to public health emergencies
- GOAL 7: Achieve excellence in management practices

- The HDC Program is Consistent with All
- HRSA Strategic Goals (2005–2010)

## 2004: Redesign into PHC strategy
2005: Make pilots and demos of integration
2006: Integrate high-leverage pilots/demos
2007: Complete all health centers
2008: 16 million patients in the registry
2009: Collect data on PHC outcomes
2010: Be ready to report as a system on health outcomes measures of all 16 million patients anticipated to be under our mutual   responsibility by then

- 2005: Make pilots and demos of integration
- 2006: Integrate high-leverage pilots/demos
- 2007: Complete all health centers
- 2008: 16 million patients in the registry
- 2009: Collect data on PHC outcomes
- 2010: Be ready to report as a system on health outcomes measures of all 16 million patients anticipated to be under our mutual   responsibility by then

- Overall Strategic Timeline of the
- HRSA Health Disparities Collaboratives

## Institutionalize quality into the HC program expectations and into the supporting infrastructure, both as defined in the IOM report and as applied operationally via the systems change management approach. 
In order to eliminate health disparities in the country, exceed all HP2010 Measures with all 16 million HC patients, as a system of HCs, and have the data to prove it.

Reference: Healthy People 2010

- In order to eliminate health disparities in the country, exceed all HP2010 Measures with all 16 million HC patients, as a system of HCs, and have the data to prove it.
- Reference: Healthy People 2010

- Overall Strategic Goals of the
- HRSA Health Disparities Collaboratives

## Goal: Improve Quality of Care – Low Birthweight

- Sources: Uniform Data System, 1999–2003
-                National Center for Health Statistics (NCHS) – Health U.S., 2003
**	**

## For More Information  

**Ahmed Calvo, M.D., M.P.H., FAAFP**
**Chief, Clinical Quality Improvement**
**Division of Clinical Quality**
**Bureau of Primary Health Care**
**Health Resources and Services Administration**
**U.S. Department of Health and Human Services**
**Phone: 301-594-0818**
**E-mail: **ahmed.calvo@hrsa.hhs.gov

**Health Disparities Collaboratives Web site: ****http://www.healthdisparities.net**