Quality Improvement and Assurance

The Quality Improvement and Assurance program is put in place to monitor and evaluate the quality and suitability of clinical care provided through DFDR. The National Committee for Quality Assurance (NCQA) is an organization whose goal is to improve the health care system and elevate health care quality. The NCQA recognizes DFDR as a Patient-Centered Medical Home and for excellence in diabetes and heart/stroke care.

In order to receive this recognition and incorporate the NCQA seal in DFDR’s materials; DFDR has to pass a rigorous, comprehensive review, and must annually report on their performance. This seal is widely recognized symbol of quality and a reliable indicator that DFDR is a well-managed organization and delivers high quality care and service.

The Quality Assurance Committee for DFDR meets prior to each Board Meeting and includes the Medical Director, health care providers, clinical support staff, Chief Executive Officer, Chief Operating Officer, and Board members. The purpose of the QA committee is to monitor and evaluate all areas of patient care including, but not limited to, the following:

  • Effectiveness
  • Acceptability to patient
  • Accessibility / Availability
  • Efficiency / Appropriateness
  • Continuity of Care
  • Patient Satisfaction
  • Integrating information regarding planning for participation in the Health Disparities
  • Collaborative in our monthly QA agenda
  • Administrative Processes

Health Disparities Collaborative

The mission of the Health Disparities Collaborative is to ensure that all people receive care that is high quality, evidence based, integrated, and patient centered. We work to ensure that health care for patients from underserved populations is equal to and as effective as the care received by the general population.

The Health Disparities Collaborative illustrates its excellence in practice through the following:

  1. Generating and documenting improved health outcomes for underserved populations
  2. Transforming clinical practice through models of care, improvement, and learning
  3. Developing infrastructure, expertise, and multi-disciplinary leadership to support and drive improved health status
  4. Building strategic partnerships

DFD Russell Medical Center began participating in the Collaborative by focusing on diabetes care (DM). The graphs below show our progress as we developed systematic changes in the way we care for diabetics. The dotted line indicates the National Goals for diabetes care and the markers indicate where DFD is in relation to the targets. DFD exceeds the standard of care in 7 out of 8 measures.

Pathways to Excellence

The “Pathways to Excellence-Primary Care” initiative was designed to get information concerning the quality of care of primary care physician practices out to employees and reward those practices which can demonstrate high quality care. Similar approaches have been launched across the nation. The initiative, Pathways to Excellence-Primary Care is intended to measure, report, and improve the quality and value of healthcare in Maine at the Primary care level. DFD has participated by reporting measures for diabetes, cardiovascular disease, depression management, smoking cessation counseling, and body mass index measurement.

Anthem Quality Insights

Anthem has implemented a program that will recognize and compensate providers for improved health care quality, patient safety, and clinical outcomes. The program requires data mining in the practice for patients with diabetes, cardiovascular disease, childhood and adolescent immunizations and well visits. DFD will receive the full 6% increase in reimbursement rate due to excellent performance in all measures.