QUALITY

Creating & Implementing a QUALITY INSTITUTE in Your Practice

Michael S. Morelli MD, CPE, FACG

President, Indianapolis Gastroenterology and Hepatology, Indianapolis, IN ALL PHYSICIANS want to provide high-quality care to their patients. It is part of a universal mission in the medical profession, although accomplishing that goal is more difficult than simply professing it.

In today's medical environment, it is incumbent upon physicians to actually prove the quality of care they claim and strive to give. Patients, insurance companies, health care systems, and the Centers for Medicare and Medicaid Services (CMS) all demand this. Thus, proving quality care is important for many reasons including improving patient outcomes, lowering cost of care, attracting more patient referrals, improving satisfaction rates among patients and referring physicians, and improving reimbursement.

Providing—and proving—this high-quality care requires a culture devoted to quality, baseline metrics and benchmarks to measure and aspire to, and an information technology (IT) and work force infrastructure to document and submit measures.

A CULTURE OF QUALITY IN INDIANAPOLIS

In 2015, our group developed the Quality Institute at Indianapolis Gastroenterology and Hepatology (IGH), with the goal of developing a dedicated and structured approach to providing high-quality care to our patients. This essentially became another department of our practice, no different in a sense from the Revenue Cycle Management Department, Scheduling Department, Medical Records Department, etc. 

I met with our partners at a board meeting and discussed my idea and the merits of the program. Although they understood this project would require time and money, they readily agreed to pursue it. Andrew W. Crane, MD, agreed to take the role of Physician Champion. Clinical Nursing Manager Cheryl Michael agreed to be the Nurse Liaison for the program and to do much of the ground work. We met with our IT vendor to discuss how they could help us devise the program and put the infrastructure in place to measure our quality metrics. With time and frequent meetings, the program has really taken off and become a source of pride in our practice. The creation of the Quality Institute has allowed us to devise efficient ways to measure and report quality in both our endoscopy services and clinicbased services in the areas of inflammatory bowel disease and liver disease. We market the work of the Institute on our website and have shared what we are doing with referring physicians, patients, self-insured companies, hospital systems, and thirdparty payers, with great feedback.

Strategies & Tactics You Can Use in Your Practice

The steps we took to create the Quality Institute at IGH that your group can replicate include the following:

Get buy-in from your group

to appreciate the importance of this program, understanding that it will cost time, human resources and money.

Choose a Physician Champion

of the program. This may require extra compensation for this person depending on how your group compensates its members.

Choose a Nursing Champion

to act as a liaison from the Physician Champion to the other physicians and to the IT vendor. This may require extra compensation.

If feasible, choose one other physician

to help the Physician Champion oversee the entire program.

Involve your IT vendor

to help develop the measurement tools and reporting capability of your progress.

Choose metrics and benchmarks

based on your scope of practice.

Measure.

Report results.

Institute a quality improvement plan

to get better at what you are measuring.

Market results

to patients, referring doctors, self-insured companies and standard insurance companies.

Submit your results

as a part of your MIPS composite score.

Expand the program

to encompass more areas of your practice. For example, expand from simply endoscopy to the clinic and create disease management protocols for liver disease and inflammatory bowel disease.