Learn about quality improvement concepts and processes that you can apply to your practice. Share your QI experiences with other members.

Quality Education

Systems Analysis and Quality Improvement Tools and Resources

Before developing and embarking on your improvement plan you will want to review and assess your practice systems and processes to identify areas that may be contributing to your current performance results. By reviewing this information in a systematic way, you will be able to get a clearer picture of where changes can be made in your practice that will help improve your performance results.

Links to several systems analysis and quality improvement tools are provided below. You are encouraged to review these tools and work through a systems analysis exercise with the staff in your practice, always keeping in mind the EPR-3 baseline area(s) you have identified for possible improvement. Once you have completed this activity you will be able to develop a problem statement and develop your improvement plan.

Basic Quality Improvement Tools

Tools, Worksheets and Questionnaires

The Dartmouth Institute Clinical Microsystems: toolkit, workbooks, and worksheets

The Quality and Safety Education for Nurses (QSEN) Institute - resources for teaching in academia or practice:

HealthIT.gov: ambulatory and inpatient QI worksheets that will assist in documenting, analyzing and planning enhancements to information flows for specific quality improvement goals.

The Institute for Healthcare Improvement (IHI): The Quality Improvement Savings Tracker Worksheet may be used throughout the organization to track cost savings associated with waste reduction efforts and to adjust for annual changes.

Community Health Association of Mountain/Plains States (CHAMPS): Several printable worksheets including Asthma and Diabetes flows, audit tools and assessments.

Important QI Concepts

PDSA: Plan Do Study Act. You can use plan, do, study, act (PDSA) cycles to test an idea by temporarily trialling a change and assessing its impact. This approach is unusual in a healthcare setting because traditionally, new ideas are often introduced without sufficient testing.

PDSA Cycle

The four stages of the PDSA cycle:
Plan - the change to be tested or implemented
Do - carry out the test or change
Study - data before and after the change and reflect on what was learned
Act - plan the next change cycle or full implementation

Six Sigma: Six Sigma is a set of techniques and tools for process improvement that originates from the automobile industry with motorola in 1986. It asserts the need to reduce process variation, identification of characteristics that can be measured, analyzed, controlled and improved; and buy-in from all stake-holders, including those in management positions.

Lean: Lean, also originally from the automobile industry, focuses on the customer (patients, regulatory bodies, payers, and providers) to determine what the customer would consider of value. Lean emphasizes empowering individual employees to improve quality, expecting every individual employee to exhibit vigilance in identifying and addressing poor quality and waste.

Learn more

Quality Showcase

Share your QI projects and experiences with other AAAAI members in the Quality Showcase. Complete the online form to submit a description of your project and it will be posted in the discussion board below. Review the board to read about others' projects and experiences, and post comments and questions for the project authors and other readers.

To submit your QI project: complete the Quality Showcase Submission Form.

Quality Measures

The Joint Task Force on Quality and Performance Measurement is a task force of the AAAAI and the American College of Allergy, Asthma and Immunology. The task force has developed several sets of quality measures covering allergen immunotherapy, allergic rhinitis (currently under review), drug allergy and urticaria. Primary Immunodeficiency measures have also been developed by the Primary Immunodeficiency Committee of the AAAAI. Please contact the AAAAI at info@aaaai.org if you would like to review one or more of these quality measure sets.

In addition, the AAAAI has made changes to its Quality Clinical Data Registry (AAAAI QCDR) for allergist and immunologist to participate in the new CMS quality payment program known as the Merit-based Incentive Payment System (MIPS) beginning in 2017 under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 

The AAAAI QCDR has been collecting data for reporting years 2014, 2015 and 2016 for the Physician Quality Reporting System (PQRS) program, which will now be reported under the new MIPS program - Quality Performance Category - starting in 2017. 

To learn about the MIPS Quality reporting criteria via the AAAAI QCDR, go to www.aaaai.org/qcdr or send an email to quality@aaaai.org

Additional Quality Measure Resources:
CMS Quality Payment Program (QPP) Measures
National Quality Forum (NQF) Measures Library
Physician Consortium for Performance Improvement (PCPI) Measures Library
American College of Chest Physicians Performance Measures Database
National Committee for Quality Assurance (NCQA)

Agency for Healthcare Research and Quality (AHRQ) Measures
AAAAI QCDR Quality Measures Set for 2017 MIPS Reporting (Link coming soon)

Publications:
Quality Measures in Allergy, Asthma, and Immunology
Quality Measures and Their Importance to Allergy/Immunology
Q&As from AAAAI members regarding AAAAI quality measures, regulatory issues, and future landscape