California Quality Collaborative Improves Patient Experience

Provider group organizations that have participated in the California Quality Collaborative (CQC) since 2006 have doubled their rate of improvement in key dimensions of patient experience compared to other California medical groups. The Collaborative helps organizations implement key changes at practice sites to improve and sustain patient ratings. The benefits of participation include:

• Learning key changes to improve patient experience PAS scores;
  
• Receiving local and national expert assistance to implement the changes in their organization;
• Learning how to motivate practices to make changes;
• Training in patient communication skills; and
• Sharing practical strategies with other California physician groups to improve the patient experience.

The Improving Patient Experience Collaborative is an 18-month program designed to improve medical group's Patient Assessment Survey (PAS) results, an important indicator of patient experience with their doctors and a key metric in the Integrated Healthcare Association's California Pay for Performance Program. Measurable improvements have been documented in patients' overall rating of care, their interactions with doctors, access and coordination of care.

Improving Self-Management Support for Patients

Self-management support plays a key role in chronic disease management, and patients can provide feedback on the most effective provider practices. A California HealthCare Foundation-funded study conducted by the Pacific Business Group on Health correlated patient experience of provider self-management support with process and clinical outcome measures.

The study included more than 150,000 randomly selected patients of 174 medical groups throughout California. Of the patients, 41% (about 61,000 people) indicated they had a chronic condition. The analysis focused mainly on patients with one or more of seven conditions: asthma, diabetes, hypertension, cardiovascular disease, back pain, depression, and arthritis. The purpose of the research was to:

• Characterize chronic care performance across California medical groups;
• Identify opportunities for improvement; and
• Contribute to a chronic care performance feedback mechanism for providers.

On average, about 70% of California patients with chronic conditions reported getting self-management support from their health care providers. The experiences of people with different conditions varied, with diabetes scores significantly higher than the others. Providers that used teams to provide self-management support - including non-physicians such as nurse practitioners, nutritionists, and/or physical therapists - scored higher than those that did not.

Medical practices varied widely in the extent to which they provided self-management support and the specific chronic conditions for which they provided it. Primary care physicians seemed to do a better job for those with cardiovascular disease, back pain, and arthritis, while specialists received better patient experience scores for asthma, diabetes, and hypertension.

There is evidence of a relationship between providers' patient self-management support and clinical outcomes for the chronically ill. More work is needed to understand the strength and nature of this relationship. View article.

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