A Q&A with Charisse Coulombe, HQIC Program Manager and Melissa Perry, HQIC Project Coordinator

What is the Iowa Health Collaborative what is its history with the Centers for Medicare & Medicaid Services (CMS)?

The Iowa Healthcare Collaborative (IHC) is a provider-led, patient-focused nonprofit 501(c)(3) organization dedicated to sustainable healthcare transformation. Created in 2004 through a partnership between the Iowa Hospital Association (IHA) and the Iowa Medical Society (IMS), IHC uses a multi-stakeholder approach to bring together and engage providers, hospitals, payers, businesses, communities, and government. These partnerships enable IHC to rapidly deploy best practices, use data to effect change, enable cross-sector collaboration and ultimately raise the quality, safety and value of healthcare in Iowa and across the nation. IHC has a long history of serving as a prime contractor for CMS. Since 2012, IHC has led the Partnership for Patients (PfP) Hospital Engagement Network (HEN), Hospital Improvement Innovation Network (HIIN), and Hospital Quality Improvement Contractor (HQIC) campaigns. Participating hospitals collectively prevented more than 36,916 harms with an estimated cost savings of at least $285,263,007.

What does the structure of the Compass HQIC network look like?

Compass is primarily composed of rural and critical access hospitals in Iowa, Kansas, Mississippi, and South Dakota. State partners include Kansas Healthcare Collaborative (KHC), Mississippi Hospital Association (MHA), and South Dakota Association for Healthcare Organizations (SDAHO). The Compass Network stands at 112% recruited to date with 283 of the targeted 252 hospitals with executed Compass Commitment Charters signed by both hospital CEOs and quality leaders.

How was the Compass HQIC able to meet the recruitment target so quickly following contract initiation?

The Compass Network developed a complete HQIC recruitment and enrollment campaign prior to award to enable swift effort and expedited enrollment. IHC President and CEO along with the Program Manager delivered a co-signed invitation letter to all targeted hospitals granting them access to Compass enrollment products. Hospital Association leadership also delivered letters of support to their members encouraging them to select Compass as their HQIC. State partners convened multiple individual and system level calls, meetings, and electronic exchanges to engage hospitals in the HQIC program.

How did the Compass HQIC assess hospital needs?

Compass conducted a comprehensive Compass Hospital Readiness Assessment (CHRA) to ensure that hospitals have the appropriate capabilities to meet the HQIC goals. The CHRA was comprised of qualitative and quantitative data to aid in assessing the current state of processes and infrastructure. Assessment design included the CDC Comprehensive Hospital Preparedness Checklist for Coronavirus Disease, current performance against HQIC measures, leadership and board engagement activities, and organizational strategic priorities. The Compass team evaluated the findings and use results to formulate a Quality Improvement Work Plan (QIWP). Prepared in partnership with the hospital, this plan memorializes the collective commitments of the hospital, Compass, and key community stakeholders in addressing prioritized QI goals for a twelve-month period. The plan includes specific, measurable, achievable, realistic, and timely (SMART) goals that provide milestone markers to promote accountability and set the pace for meaningful action steps that translate to quantifiable improvements.

How does Compass ensure sustainability and maintain momentum of the program?

Compass established program cycles defined by a specific 90-day HQIC performance period that coincides with the graduated payment plan to sustain network program efforts and maintain project momentum. Each cycle Compass creates a Targeted Attainment Report (TAR) to assist IHC and state partners in identifying the harm areas most at-risk for not meeting HQIC program goals. Compass then develops low performer reports in these harm areas to identify hospitals in need of targeted technical assistance (TA) over the next 90 days and incorporates these efforts into a cycle specific TA strategy which provides SMART goals, tasks, and millstones that document key programmatic movements and the cadence for activities. In addition, Compass develops an education and training strategy that aligns with and complements the TA strategy for each cycle. The Compass education strategies are a guide for the HQIC but remain fluid and easily adaptable to address emerging needs of the network such as public health emergencies and natural disasters. In addition to the TAR, the education strategy is informed by the CHRA, QIWPs, and feedback from the Compass Rural Health Advisory Panel, a group of hospital quality leaders throughout the network. Using the Kirkpatrick Evaluation Model for training assessments and post training evaluations, Compass is able to determine the hospital-level behavioral change as a result of the training and monitor quantitative impact on the program measures.