Achieving a High-Performing Health System in Ohio

A report on the Ohio Health Quality Improvement Summit

Executive Summary (download pdf 320k)

Full Report (download pdf 981k)

More than 180 health care leaders from various organizations and agencies throughout the state attended the Ohio Health Quality Improvement Summit, November 17-19, 2008, in Columbus, Ohio. The summit resulted from Ohio’s participation in the Commonwealth Fund/AcademyHealth State Quality Improvement Initiative (SQII) with the specific goal of developing 12 strategies and related tactics needed to transform Ohio’s health care sector into a high quality, cost-effective, high-performing system that will optimize the health of all Ohioans. Ohio was one of nine states to participate in SQII.

Prior to the summit, conference organizers appointed four work groups to assemble background reading materials and develop preliminary recommendations in the following focus areas: (1) improving chronic care management; (2) improving patient safety and reducing errors; (3) promoting health and preventing disease and injury; and (4) improving efficiency and decreasing cost. Summit participants, at the time of registration, were asked to select the focus area of their preference and were e-mailed applicable background materials and preliminary recommendations to read prior to the summit.

The first day of the summit began with nationallyrecognized speakers assessing the status of health care in Ohio and outlining national reform efforts underway in other states. Participants then broke into the four focus group areas, led by a facilitator. Each group was instructed to identify a maximum of four strategies with related tactics, using pre-conference background materials, which they believed have the greatest potential for improving the

quality of the health care system and health care in general. In addition, facilitators instructed each group to address four cross-cutting concepts which affected all

areas. These included health disparities, health information technology, payment reform and workforce development. Over the course of the summit, two additional cross-cutting issues were also identified – transparency and organizational structure/leadership.

On the second day, the groups reconvened as a whole and ranked the 12 recommended strategies developed by the four focus groups in the following order of importance:

1. Advance a sustainable community specific Chronic Care Model with a prepared, proactive practice team and an informed activated patient that focuses on improving outcomes.
2. Promote a culture of physical and emotional health and wellness through lifestyle options that comprehensively address decreasing the prevalence of the most pressing population health issues: depression, obesity and tobacco (use).
3. Transform health care delivery through patient-centered primary and preventive care.
4. Increase the percentage of Ohioans receiving the recommended primary and secondary preventive health services appropriate to an individual’s age, gender and condition.
5. Reduce (eliminate) preventable error rates by improving communication during handoffs

   and transitions.

6. Decrease the non-value added administration and transaction costs of financing and

   delivering health care.

7. Create an environment for patient-centered, informed decision-making around end-of-life

   care.

8. Utilize evidence-based medicine and management to reduce unnecessary and non-value

   added care.

9. Promote a system-wide culture of safety.
10. Reduce (eliminate) preventable health care associated infections.
11. Reduce (eliminate) preventable adverse drug events.
12. Prevent injuries with specific emphasis on fall related injuries, poisoning, youth injuries

    and motor vehicle injuries.

After ranking the 12 strategies, the focus groups reconvened and developed tactics for the top one or two

strategies in their focus area.

These tactics were then presented by each group to all conference participants during the third day. As

the summit reached its conclusion, participants expressed a strong commitment to reform and asked that

the resulting recommendations be carefully considered and acted upon.

Immediately after adjournment, conference organizers convened an implementation team from various

statewide organizations and agencies to determine next steps and compile information from the summit.

The remainder of this report is dedicated to outlining in greater detail the strategies and tactics put forth

by the summit participants.

The SQII team placed a priority on creating this report both for those in attendance and those interested

in health reform who could not attend. Summit attendees and other interested stakeholders are asked

to review the report and provide feedback throughout December 2008 and early January 2009. The

Implementation Team will utilize the feedback provided to create a draft action plan. This draft plan

will be reviewed at a follow-up meeting that will be held in April 2009

It is important to note that recommendations identified during the summit should only be viewed as a

framework for health care reform in Ohio, and not as an all-inclusive action plan needed to transform

Ohio’s health care sector. As you review this report, please recognize that each focus area report differs

based on the stage of tactic development reached during the summit. This report is not intended as a final

action plan but an initial assessment.

Additional information about the summit and next steps for transforming Ohio’s health care system,

including pre-conference materials and this report, and be found at http://ohqis.pbwiki.com.