North Carolina AHEC Program
winter 2012 newsletter | home

NC AHEC Quality Improvement Initiative Receives Grant from The Duke Endowment

In November 2011, The Duke Endowment awarded a three-year grant of $815,089 to the NC AHEC Program to enable AHEC’s Quality Improvement Coaches (QICs) to provide on-site training and facilitation in more than 400 primary care practices statewide.

“With more than five years of experience providing coaching on quality improvement, AHEC has learned that the most crucial part of helping a provider to improve the provision of care is to gain real-time, point of service data from electronic health records (EHR),” said NC AHEC Associate Director for Statewide Quality Improvement Ann Lefebvre, MSW, CPHQ. “When gained on a regular basis (at least monthly) this data can be used to quickly provide information to the clinical staff as to the efficacy of the care provided to their patient population. Data is a powerful tool and when used well, can help drive the layers of changes necessary to improve clinical care.”

Through NC AHEC’s work as a federally funded regional extension center for health information technology (REC), the NC AHEC Program has succeeded in helping practices across the state implement or reconfigure their EHR software systems. AHEC is now working in over 1,000 primary care practices in the state on EHR adoption, and many of these practices have a great interest in pursuing the knowledge and skills necessary to begin using data from their EHRs to improve the quality of care provided.

With this grant, AHEC will expand the number of practices receiving practice-based quality improvement coaching services by four-fold over the next three years. AHEC will launch a recruitment campaign to engage at least 400 primary care practices with a quality improvement coach to improve their delivery systems and clinical outcomes in diabetes, asthma or hypertension care. The aim is to achieve a 30% improvement between baseline and goal in specific diabetes, asthma and hypertension measures over the period of this grant.

AHEC will also use the opportunity of its work in these practices to promote the elements of patient-centered medical homes. The work of the REC, paired with the additional QI efforts from The Duke Endowment grant, align entirely with the concept of building medical homes for patients in primary care offices. AHEC will encourage practices to integrate the elements of patient-centered care into their organizations, enabling them to transform their practice cultures and sustain the efforts of medical home activities.

“We need to transform the way they deliver health care by giving doctors the tools, systems and support they need to provide consistently high quality care to all patients at all times,” said Samuel Cykert, MD, clinical director of the NC REC and professor of medicine in the UNC-Chapel Hill School of Medicine. “The delivery of this information needs to be done in a way that can help the provider to assess his/her own practice and embed improvements in practical systems. These solutions need to be implemented in a methodical and tested fashion in order to sustain improvements over time. Unfortunately, many ambulatory practices are not currently skilled in the techniques needed to make these changes while maintaining their current capacity and viability. It is our experience that learning of this type cannot be done from a lecture or webinar and needs to engage the entire practice to truly achieve the gains that are necessary.”

Since 1924, The Duke Endowment has worked to help people and strengthen communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits. Located in Charlotte, NC, the Endowment seeks to fulfill the visionary genius and innovative legacy of James Buchanan Duke, one of the great industrialists and philanthropists of the 20th century.