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    Quality initiatives: How to participate—and benefit

    Quality improvement efforts will impact your bottom line under MIPS


    Getting started: The steps

    Before starting a QI program, urologists should get basic QI training, according to Dr. Chrouser. There are different QI approaches from which to choose, including Continuous Quality Improvement Cycles, Six Sigma, and lean methodologies.

    “The research training most of us received as residents is not quite QI specific enough to get you started,” she said.

    Read - Drug importation: Shortsighted and ineffective

    The second step is to define the problem, which requires looking at a process from various perspectives. If it’s a process in a hospital, for example, the urologist would talk to administrators, secretaries, and nurses and determine why something happens the way it does—what the rationale is, according to Dr. Chrouser.

    “Particularly if you’re doing hospital-based QI, there are a lot of people in the hospital who can help you. There might be a QI department or a patient safety officer or an infection control person, and those individuals can really help with data,” she said. “You need a measurable outcome of some sort; then you make a change and re-measure it. That’s the QI cycle.”

    Khurshid R. Ghani, MD, MSDr. GhaniUrologists looking to start collaboratives need to get a source of funding and develop a leadership structure and team, according to Dr. Ghani.

    “It really is a team effort, and it requires urologists to work together across the spectrum and come together around a simple and positive mission,” he said.

    Dr. Ghani says that QI initiatives require effort, including data entry.

    “This can be manual data entry, which is what we do in MUSIC,” Dr. Ghani said. “We train data extractors in each practice to put in high-quality data, which we regularly audit to assess for quality and accuracy. Or they could be involved in something like the AQUA Registry, where the registry links in with the practice EHR and extracts certain data elements using natural language processing techniques.”

    Also see: Urologists show low adherence to value-based care pathway

    QI also takes an organizational commitment.

    “Each practice has to identify one urologist who is known as the clinical champion and provides the local leadership for QI projects,” Dr. Ghani said.

    Next: Choosing the right QI project for your practice

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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