When he found out Children’s Health Network (CHN) had won the 2019 Leadership in Quality Award, Senior Vice President and CHN Executive Director Bob Finuf knew what they’d do with part of the award’s $5,000 prize money:
Make 23 replicas of the award’s trophy—one for each of Children’s Health Network’s participating practices.
“It’s the practices that have done the heavy lift in order to achieve the aggregate results that we have realized so far. It’s their work this award recognizes," Finuf said.
The Leadership in Quality awards are presented annually by the Kansas Healthcare Collaborative and the Kansas Foundation for Medical Care, Inc. to health care providers and health care organizations to recognize leadership in quality improvement and patient safety. A cash prize of $5,000 is presented to the grand prize winner, thanks to the generous sponsorship of the KAMMCO Foundation.
The awards were presented at the 2019 Summit on Quality in Wichita by Jerry Slaughter on behalf of the KAMMCO Foundation board of directors.
“KAMMCO Foundation is proud to recognize and reward the quality improvement efforts of Kansas health care providers,” Slaughter said. “The providers nominated and selected for the awards are truly leaders and innovators in improving the health of communities, enhancing the experience of patients, and helping reduce overall cost of care.”
Jon Rosell, co-executive director of KHC, said the Leadership in Quality awards were created in 2013 to recognize individuals and organizations in Kansas who dedicate time, energy, and talent to ensure safe, quality care for Kansas patients.
“We congratulate all four of this year’s honorees and are proud of their work here in Kansas,” said Rosell. “The quality improvement work being done by leaders across Kansas is making a difference in the lives of patients, even while it may not come with a ‘quality improvement’ label on it.”
‘Quality improvement is at the core of what we do’
Children’s Health Network (CHN) has come a long way since Children’s Mercy Kansas City formed the network and began partnering with community-based, independent pediatric practices in 2015, Finuf said.
“Quality improvement is at the core of what CHN does now," Finuf said, noting 10 of the current 23 practices are in Kansas. “But there was a pretty wide spectrum of engagement in quality improvement when we started. All of the practices have improved from a quality improvement perspective compared to where they were when CHN was formed.”
Participating practices have access to a variety of resources to improve quality and reduce cost, including a web-based population health management platform to integrate near-real time data to perform quality/cost performance analytics, pre-visit planning and patient outreach. They also receive quarterly reports that evaluate their performance along 30 measures. The reports include the performance of other practices within the network and are based on data collected directly from payers, providers, and external laboratories.
"That kind of data transparency environment was a fundamental and important step in the progress we’re making," Finuf said. “In the early stages, there were some awkward moments, but the key is to start to build trust in the data. We did a lot of deep dives and working individually with practices. We didn't share a practice’s data until we've been able to validate it with them—that they believe in the data itself."
“Nobody wants to be at the bottom of a performance list. Physicians are generally competitive anyway, so this really did provide an atmosphere where everybody was motivated to improve,” he said.
So far, the network has achieved significant improvement, ranging from 7 to 57 percentage point increases, across 12 measures.
The magnitude and pace of CHN’s quality improvement efforts is truly impressive, said Tom Bell, co-director of the Kansas Healthcare Collaborative.
“That kind of change in culture and resulting success—implemented through ongoing process management and improvement efforts—exemplifies the goals Kansas Healthcare Collaborative has set with the Leadership in Quality Award,” he said.
Collaboration and information sharing key
Luke Harris—Director of Operations & Population Health Management—stressed that the success of the network is rooted in its five founding principles, namely:
- A focus on the patient and the Triple Aim of better care, smarter spending, and healthier children;
- Being provider led and professionally managed;
- Transparency and trust;
- Data driven strategy and decision making; and
- Collaboration & open communication.
“These principles continue to be the basis of how we operate and drive performance improvement,” Harris said.
Additionally, he said, there are at least two other key ingredients to the progress the network is making. One is the technical infrastructure; another is having sufficient scale to establish and help define pediatric value-based agreements with payers.
“An individual independent practice often does not have the ability or influence to move toward value-based care,” Harris said. "As a network, we can collectively build and invest in the technology infrastructure and integrate data from disparate sources in a meaningful way, driving value and improved health outcomes for the communities we serve.”
Likewise, he said, the network provides practices the ability to establish and help define pediatric value-based contracts with payers.
"Your ability as an individual practice to negotiate directly with a payer for a value-based agreement is very limited, because it’s challenging and typically cost prohibitive for payers to administer value based agreements at that level—particularly for pediatrics which tend to have healthier populations and represent a small percentage of the overall spend on health care," Harris said. “Together, though, we as a network can help define what pediatric value-based care looks like now and into the future.”
In time, affiliate practices in the Children’s Health Network will likely continue progressing toward more value-based care payment contracts—assuming more risk, but with the ability to share in the savings they generate, said Bob Finuf.
“Government and other payers have indicated they intend to shift more and more to performance-based payment,” he said. “A greater and greater percentage of what we're paid will be subject to nonpayment if we don't hit certain quality and cost performance measures. If you believe that evolution is going to continue, you should be in an environment where you can continue to improve your performance.”
The Leadership in Quality awards are presented annually by the Kansas Healthcare Collaborative and the Kansas Foundation for Medical Care, Inc. at the Summit on Quality in Wichita. More information on the Leadership in Quality awards—including updates on the call for nominations for the 2020 awards—is available at: KHConline.org/leadershipinquality.
2019 Physician Champion Award winner
This year, the Kansas Healthcare Collaborative also recognized its first Physician Champion; the award reflects the important role physicians play in the quality improvement process and honors an individual who has consistently empowered others on the improvement journey.
The 2019 Physician Champion honoree is Dr. Craig Concannon, who received his award at the May KHC board meeting. Dr. Concannon is an internal medicine physician at Beloit Medical Center. In nominating him, his colleagues stressed how critical Dr. Concannon's leadership is in furthering the overall organization's quality improvement efforts. They said he works to empower staff members to be on the leading edge with quality measures. Further, he serves to educate on quality statewide through the Kansas Clinical Improvement Collaborative (KCIC) and belongs to an Accountable Care Organization (ACO). Staff members said there is a culture of pride in being leaders in the state via the clinic ACO, Beloit Medical Center, P.A.—which helps further advance continuous quality improvement.
2019 Award of Merit
Nora Elizalde is one of two honorees for the 2019 Award of Merit. She is a certified nurse midwife at Bob Wilson Memorial Hospital—which is part of Centura Health—in Ulysses. In nominating her, Nora's colleagues praised her for ensuring expanded access to high-quality prenatal and delivery services across southwest Kansas and the Oklahoma panhandle. In addition to the hospital in Ulysses, she also has a clinic in Liberal and in Guymon, OK—meaning Nora travels more than 500 miles a week treating expectant mothers. Beyond being an exceptional midwife, Nora is uniquely qualified to best treat many women thanks to her Spanish fluency and Mexican heritage. She brings with her empathy, strong listening, and a genuine ability to connect with each one of her patients. Nora embodies whole person, patient-centered care.
2019 Award of Merit
Niki Lamb is also one of two honorees for the 2019 Award of Merit. She is a registered nurse and director of quality assurance, infection control, and risk management at Sumner County Hospital District #1 in Caldwell. In nominating her, Niki’s colleagues praised her for continually going above and beyond on behalf of patients. Among her most recent efforts they detailed: a rigorous hand hygiene program; development of a Quality Council; ensuring staff are fully vaccinated; diligent work with staff to maximize use of the EHR; and proactive involvement in the community to promote health and wellness outside of the facility. Her colleagues remarked that “Niki’s passion for the health and wellness of others permeates our facility and our community.”
• • •
The Kansas Healthcare Collaborative is a provider-led 501(c)3 nonprofit organization with a mission to transform health care through patient-centered initiatives that improve quality, safety, and value. Founded in 2008 by the Kansas Medical Society and Kansas Hospital Association, KHC embodies the commitment of two of the state’s leading health care provider groups to act as a resource and continuously enhance the quality of care provided to Kansans.
• • •
→ Find more information on the Leadership in Quality awards—including updates on the call for nominations for the 2020 awards—at: KHConline.org/leadershipinquality.