State Quality Improvement Institute (SQII)

In 2008, AcademyHealth and The Commonwealth Fund launched the State Quality Improvement Institute (SQII) - a technical assistance project for states that have made or are ready to make substantial commitments to health care quality improvement. The nine states competitively selected to participate are Colorado, Kansas, Massachusetts, Minnesota, New Mexico, Ohio, Oregon, Vermont, and Washington.

The SQII facilitates ongoing collaboration between and among high-level state executive, Legislative, municipal and private-sector team members, and provides opportunities for contact with expert faculty to support care improvement in three priority areas: 1) delivery and financing systems reform, 2) care coordination/chronic care management, and 3) data integration/transparency.

PHASE 1
In the first year of the SQII, participating states were required to develop, refine, and begin executing on specific improvement strategies outlined in their Action Plans. Important strategies now under way include implementation of medical homes and care coordination initiatives; adoption of population health programs to reduce chronic disease risk in the community; enhanced chronic disease management to improve outcomes and avoid costly hospitalization/ avoidable re-hospitalization; and use of data for performance improvement and public reporting.  SQII staff and expert faculty have worked closely with the state teams to support their efforts to identify and adopt evidence-based models for systemic transformation.

AcademyHealth has released an overview and progress report that describes important elements of the technical assistance provided in Phase 1, outlines the preliminary efforts of the participating states, and highlights some early examples of progress.

PHASE 2
Through a combination of in-person and virtual meetings, as well as ongoing technical assistance, the SQII continues its work with the original nine state teams.  Primary objectives for Phase 2 include:

• Assessing and addressing new challenges faced by individual states;
• Providing customized support and strategic guidance to states;
• Assisting with the execution of their Action Plans, including: 1) Identification of appropriate diagnostic and implementation tools, 2) analysis of possible approaches, 3) consideration of policy tradeoffs, and 4) refinement or revision of plans; and
• Enabling state participants to network and discuss their own experiences and best practices.

Key Components of the SQII
In-Person Meetings

• Interim Meeting (May 2009): State teams re-convened approximately one year after the original Kick-off Meeting in order to further broaden their understanding of topics critical to the achievement of their action plans.
• State Site Visits: A team from AcademyHealth and The Commonwealth Fund will visit each state to help with strategic planning and to facilitate Action Plan progress.
• Topical Meetings (Ongoing): Smaller groups of 3-4 state teams will convene in the fall/winter of 2009/2010 to focus on specific topics of interest identified during the Interim Meeting and through follow-up technical assistance needs assessments.
• Final Meeting (Spring 2010):  State teams will have the opportunity to re-convene together for the purpose of reporting out on their accomplishments, discussing what is likely to come, and reflecting back on the SQII experience.

Additional Components

• Access to Faculty: SQII will provide state participants an opportunity to consult with expert faculty (both state and national thought leaders).
• Distance-learning: SQII will host several Cyber seminars to help states drill down into specific areas of systems change.  Some of the highlighted topics from past events include: Engaging physicians in quality improvement efforts, and the state’s role in providing and collecting data to assist in quality improvement efforts.
• Regular Correspondence:  The SQII team will facilitate structured communications (e.g., monthly email progress updates, bi-monthly calls with team leaders, and one-on-one team leader calls) to encourage information sharing and relationship building, and ensure some level of accountability.
• Action Planning: States will develop, share, refine and execute on specific Action Plans - incorporating activities of multiple stakeholders and outlining the timeframe for milestone achievement.
• Implementation of Action Plan Activities: For the duration of the SQII, states will participate in SQII technical assistance activities, report on their progress, and meet the milestones established in their Action Plans.
• On-going Technical Assistance: In addition to the in-person faculty access referenced above, regular telephone and video-conferencing capabilities will be used to provide technical assistance to each state’s team, as needed.