2020 has been defined by the COVID-19 pandemic, a national reckoning with racism, and our community-wide psychological response. Like our partners across the state, the Foundation for Health Care Quality has been shaped by adapting to the challenges of the year. We continued our focus on using data to drive improvement, educating our community, developing clinical best practices and community standards, and working to transform clinical practice. We were lucky to be able to contribute to the public’s health by facilitating a series of early consensus-building conversations to address some of the many issues arising from the pandemic.

We look forward to the start of this new year with the type of guarded optimism appropriate for our day and age. Join us as we build our focus on equity, transparency, and value. If you or your networks are interested in joining our collaborative workgroups or clinical outcomes assessment programs, please reach out to us at fhcq@qualityhealth.org 

Used Data for Improvement

• Developed a obstetrics disparities dashboard that visualizes differences in process and outcomes across racial and ethnic groups with quarterly updates planned on areas impacted by implicit bias and racism
• Partnered with Microsoft to collect data on and evaluate the effects of COVID-19 on obstetric patients and with Harvard on impact of labor and delivery nurses and audit and feedback on cesarean rates
• Surveyed patient experience of care when transitioning between home and hospital births including the association of race and gender with the experience of respect and autonomy
• Held quarterly webinars to review regional data and share best practices to improve outcomes on cardiac care
• Moved toward data transparency between general and spine COAP member hospitals
• Continued to publish including on evaluating minimally invasive colorectal surgery, temporal trends in coronary intervention, and the effects of class 3 obesity on adverse obstetrical outcomes.

Educated our Community 

• Shifted to virtual meetings to share best practice for obstetrics, cardiac care, spine care, and general surgery and offer opportunities for cross-organizational networking
• Hosted a diverse array of webinars primarily focused on integrating behavioral health into primary care (e.g., suicide care pathways) with deep dives into related issues including implicit bias in clinical care and dementia care
• Partnered with the Washington State Medical Association to produce a health equity mini-series including creating sustainable systemic change, addressing LGBTQ health care, and equity best practices
• Held two state-wide summits on behavioral health integration and with the Washington Health Alliance on value-based care

Developed Clinical Best Practices and Community Standards

• Standardized diagnostic error taxonomy for adverse event reporting to improve diagnostic processes
• Developed state-wide community standards for:
  • Increasing appropriate colorectal cancer screening through tracking, measurement, and payment
  • Improving quality, equity, and cultural appropriateness of reproductive and sexual health 
  • Reducing unnecessary and potentially harmful inpatient care for those undergoing treatment for cancer
  • Defining, standardizing, and incenting appropriate spending in primary care
  • Person-centered recommendations to support those on long-term opioid therapy
• Formed a workgroup of surgeons, anesthesiologists, and other clinicians to develop enhanced recovery after surgery protocols for cardiac care

Transformed Practice

• Implemented behavioral health guidelines at 10 primary care clinics across Washington which included infrastructure to track screening for depression, anxiety, alcohol use, drug use, and social determinants of health, as well as integrated Prescription Monitoring Programs into electronic medical records
• Continued to develop implementation resources for our recommendations and guidelines
• Identified pilot sites to promote an environment of psychological safety for patients to reduce safety events and improve patient/resident satisfaction

As we look to 2021, we will focus on building an equitable health care system, delivering on value to our members, and responding to emerging needs in our changing health landscape. We are excited to advance our work on social determinants of health as we look toward developing best practices for addressing social needs in clinical settings, building educational resources to counteract stigma and discrimination, and move the needle toward more equitable clinical outcomes.

Email us at fhcq@qualityhealth.org to join our work. We look forward to partnering with you to build a more equitable system and improve outcomes through data, clinical insight, and finding common ground.