This page contains a Flash digital edition of a book.
of quality” identified by the Institute of Medicine. They are Safe, Timely, Effec- tive, Efficient, Equitable, Patient Cen- tered care (STEEEPTM

), which includes

concepts such as cost-effectiveness and value.

Officials from both systems say they

have seen demonstrable improvement in quality of care as a result of the projects initiated as part of the course. “We’ve documented that in virtually

every project, we’ve been able to show improvement,” Dr. Patterson said.” Many of those projects are sustained over time.” Dr. Fleming added that “a key to the projects is that they involve multi- disciplinary staff who develop team- work and the necessary communication essential to addressing the increasing complexities facing health care provid- ers and their patients.”

Rapid cycle improvement Dr. Villamaria says medical school and residency programs did not teach quality improvement a generation ago. While many schools now incorporate quality improvement into their curri- cula, he says, it is important for physi- cians already in practice to learn these techniques because the changing health care delivery environment — from pay- for-performance to accountable care or- ganizations to outcomes measurement — drives the focus on quality. Also, many specialty boards now require physicians to complete quality improvement proj- ects as part of the board recertification process. Luci Leykum, MD, UTHSCSA associ-

ate dean for clinical affairs and a gradu- ate of the CS&E course, agrees. “It’s critical for physicians to be active participants in improving the efficiency and quality of care we deliver,” she said.

“Training in process and quality improve- ment, such as that provided by the CS&E course, gives us the opportunity to be- come better able to contribute to those improvement efforts. It also enables us to look at the system of care delivery in a more critical way, to assess what pro- cesses could be optimized, and approach thinking about these types of issues.” UT-San Antonio otolaryngology pro- fessor Randal Otto, MD, also graduated

from the course. He says its focus on “rapid cycle improvement” means sig- nificant improvements in quality can be achieved in many cases with very little effort.

“Physicians tend to think we have to

go from point A to point B, with point B being perfection,” he said. “And we can study it or dumb it to death and never really get anything done.” But if you focus on a series of small

steps that move toward perfection, you can accomplish a great deal, he says. As his project for the CS&E course,

Dr. Otto looked at hiring translators to communicate with Spanish-speaking patients rather than pulling Spanish- speaking staff away from other tasks. Just spending more to hire translators saved time for the physicians and im- proved patient flow, he says. “Health care is filled with those kinds

of examples,” he added. “So you can show substantial improvements and cost savings in very short periods of time by just thinking about the things we do — What are we doing? Can we be more ef- ficient? What are the barriers to that? At the end of the day, that’s what clinical safety and effectiveness is.”

Be Prepared. Be Very Prepared.

TMA’s new Internet- based tool can help you be ready for the staggering number of new commercial insurance and federal and state regulations that affect you and your patients.

TMA’s Calendar of Doom gives you and your staff the big-picture view of upcoming state and federal compliance timelines and key health policy issues that impact Texas physicians.

When you log on to, you can see at a glance:

• The regulation’s details and background information;

• The consequences of not complying, penalties, and incentives;

Six Texas ACOs join Medicare pilot project

Six Texas-based accountable care orga- nizations (ACOs) are among 89 new par- ticipants added to Medicare’s share sav- ings program on July 1, the U.S. Centers for Medicare & Medicaid services (CMS) announced. Texas ACOs added to the program


• BHS Accountable Care of San Antonio, which comprises ACO group practices, networks of individual ACO practices, partnerships between a hospital and ACO professionals, and a hospital em- ploying ACO professionals, with 348 physicians;

• Memorial Hermann Accountable Care September 2012 TEXAS MEDICINE 47

NOI - 1/3 v 2.25 x 9.75

• The next steps you need to take to meet the compliance date; and

• How TMA can help you meet the deadline.

HIPAA … ICD-10 … Taxes Coding … Meaningful Use E-Rx … Medicare … PQRS (800) 880-7955

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