Next, we establish a schedule to present at each clinical specialty faculty meeting on a regular basis (semi-annually to quarterly). At these meetings we present an overall picture of the key initiatives relevant to the division, identify milestones, offer clear timelines and prioritization of these projects, and narrow the focus of work to a few bulleted action items for all levels of the clinic staff to incorporate into its workflow. We then listen to questions and concerns and bring these back to the initiative leaders so that systematic changes can be made. Answers and updates are communicated back to the divisions, thus closing the communication loop. We interface with practice managers and clinical support staff to identify opportunities for them to support physicians in meeting initiative requirements [21,22].
In addition to presenting at faculty meetings, we present updates to departmental and hospital leadership, including vice chairs and division chiefs. These meetings include high-level data on performance as well as an opportunity to discuss the challenges we identified through our discussions with individual specialties. These forums are a good place to discuss overarching process issues or to disseminate answers to previous questions.
An important part of our communication plan involves our comprehensive monthly emails. For each initiative, we receive department level data on a monthly basis from the project leadership. We deconstruct these reports to enable us to evaluate our 13 divisions individually. We show performance at the physician level and highlight general areas where improvement is needed. We send monthly e-mails to division clinical and administrative leadership to apprise them of their division’s performance and inform them of areas that require concentrated effort. Depending on the initiative, we present data as a snapshot in time or trend over time. From 2012–2017 the DOMQP has helped to bridge the gap between large-scale rollouts of the new initiatives and the vast number of DOM physicians who required more specific education and tools to meet these new requirements.
Conclusion
The DOMQP has been working on quality within the department of medicine for the past 10 years. We have moved from initiating an internal quality program among the specialty providers, which required education among faculty and resolve to overcome many IS challenges, to serving as a resource for hospital-wide quality-related initiatives. We have developed a successful architecture for disseminating information and guiding faculty and administrative support toward success on a multitude of metrics that have implications on both finances and sound patient care. We have navigated the significant challenges associated with the large-scale change due to the EHR transition we underwent in 2015, including clinician burnout and fatigue, new EHR functionality, and the development of a new data reporting infrastructure and governance. The DOMQP continues to demonstrate that quality has a multifaceted role to play within a hospital.
As the health care environment continues to evolve, the need for this level of support for clinics will increase. The DOMQP is well positioned to provide continuing support to physicians and their practices in measuring and improving quality, with attention paid to such areas as coordination and efficacy of care, patient-reported outcomes, patient safety, and population health management. We believe that the DOMQP can serve as a model of a departmental quality program.