J.1(f)_Sample_LAN_Meeting_Strategy.docx

Attachment J.1(f)- Sample LAN Meeting Strategy

HHSM-500-2014-RFP-QIN-QIO

Sample Strategy for Learning and Action Networks (LAN)

One critical function in the Quality Innovation Network QIO IDIQ Base Statement of Work is development and execution of multiple Learning and Action Networks (LANs) given the varying organizational structure that may be needed to span larger geographic regions and greater numbers of providers and beneficiaries. The design intent of a LAN is to achieve better health (through prevention), better health care (through reducing harm) and lowering health care costs (through improvement). It is important to consider the development of a LAN strategy/structure that describes how the goals are to be met and how the work will be achieved. A strategy/structure may include, but is not limited to:

· Roles of key staff,

· Organizational structure both internal and across state lines,

· Internal quality improvement processes,

· Communication systems,

· Key relationships and organizational bodies that are critical partners,

· Feedback mechanisms,

· Quality improvement practices,

· Spread and sustainability plans.

· Below are some questions (not exhaustive) that may further assist in developing your LAN strategy/structure. offerors will need to consider the organizational framework they will use to build, manage, and sustain their networks. Who are the people we serve?

· Who are the critical stakeholders in the field that we will work with to achieve the goals?

· What initiatives/platforms exist that we can align with to create synergy, efficiencies and achieve the goals?

· How will we meaningfully engage beneficiaries/patients/residents?

· Who is leading?

· Who are the change-agents in the field?

· Do we have appropriate communication flow between leaders and change agents?

· What levers will we use to achieve the goals?

· How will we create the will for change and refresh as needed? How does communication flow? What mechanisms will we use?

· How will we set the pace for achievement of the goals?

· How will we know we are successful?

· What data do we need?

· What feedback mechanism do we put in place at the organizational and field levels?

· What steps do we take when we are not successful?

· What quality improvement practices will we utilize?

· How will we drive action among our participants?

· How will we build capacity at the onset for spread and sustainability?

The following is an example of a Learning and Action Network strategy; however, QIOs are expected to provide a unique and innovative LAN strategy/structure and not simply a replication of this simple and scaled down example provided.

1. CMS communicates a national priority The QIO reviews their data to understand how the priority impacts their state and makes the case for change. The QIO begins to identify the leaders in the area of the priority or works with established initiatives/organizations. High performing organizations and/or published experts in the field are identified to serve as field agents/spread advisors.

2. The QIO activates their existing networks around the aim. The existing networks include their state based Leadership Coordinating Council (LCC), comprised of academic organizations, associations, state based health agencies etc… A group of field agents (Faculty) comprised of QIO employees based in the field and people from healthcare organizations who are passionate about the work to be achieved and who work for providers of care.

3. The LCC already has a monthly event so the information gets shared with the group in a compelling way. Using Community organizing tactics, the group decides upon a stretch aim and next steps. Using data, the group decides to work with 50 hospitals where the data point out there is an issue.

4. At the onset, the QIO will focus on quality improvement, facilitation skills, and community organizing tactics to aid in building spread and sustainability by hardwiring these practices throughout the QIO territory.

5. The QIO has pre-established across their territory 6 Learning Sessions per year. These Learning Sessions are multidisciplinary in nature and offer an opportunity for multiple initiatives/themes to be worked on and resolved. To jumpstart the most recent priority, the QIO will invite the 50 hospitals to send two to three staff for the specific purpose of working on the issue. Using evidence based tools and practices, high performers share what has worked for them. The QIO will create the opportunity for requests and offers to occur. In this commitment exercise, all participants are given the opportunity to publically commit to the actions they will take, or make requests of others in the room for assistance or things that they need to move the aim forward.

6. Post Learning Session, field agents are making house calls to assist people in the field with change implementation around specific practices that are associated with high performance. Additional supports are provided with just in time conference calls (15-30 minute calls at lunch) where small groups can work on specific hurdles, or receive PDSA’s that are proven to be successful for roll out. The QIO is constantly mining their data and understanding the practices of of their LAN.

7. The QIO is constantly building and strengthening their system with things like CEO/Board of Directors/Owners events where offers, requests and commitments are made for staff training days, policy review, barrier removal. Commitments gained at these meetings are shared at every learning session and the commitments celebrated.

8. Using X,Y,Z, System/data collection mechanism, the QIO will track the practices of providers and provide timely data results and feedback. The QIO will work to build “will” within the QIO area to make change in the priority area(s) through the meaningful inclusion of patients/residents/family members in all aspects of its work, including the leadership council, regional learning sessions, conference calls, advisory panel etc...

9. The QIN-QIO will form a Leadership Coordinating Council that will drive the work occurring in their area. The leadership council will be made up of a multidisciplinary group that represents all aspects of the healthcare system and will serve to intervene on difficult issues; make phone calls to other leaders, write letters of support, review data for trends, speak publically about the aims, implement policy that supports the aim(s).

10. The NCC will use multimedia, social marketing and adult learning techniques to support their LAN meetings and in generally moving their goals forward. The QIO supplements their face to face support with different touch-points (twitter feed, video vignette etc.) with the purpose of uptake, action and will building. The QIO will work to form self-sufficient community based affinity groups that come together to problem solve. Affinity group results will be highlighted at the learning session.

11. Following the launch, the QIO will provide technical assistance, within available resources, to help participants. The QIOs will leverage the talent in the LAN to assist those participants who have expressed a specific need. One example may include setting up mentorships and/or creating opportunities for onsite visitations of high performing organizations. QIO specific technical assistance examples include providing tools on how to communicate with Boards of Directors/Owners, or collecting best practices from those in the field and sharing them.

Sample Learning and Action Network Strategy for

X QIN-QIO

National Leadership Coordination Council Comprised of Partners from Federal Agencies, Leaders in the Industry, QIO Leadership, Patients, Advocates and other interested stakeholders (Face to Face Meetings.)

State Level Action and Learning Networks

Local learning networks come together to plan actions that will be taken in the field, monitor progress, receive information from and provide information important to national efforts.

(Meets three times a year with at least one face to face meeting. Composition to be determined by QIOs in alignment with SoW guidance)

State Level Coordinating Meetings Comprised of local experts and faculty in the field as determined by the state. QIOs will use these meeting to coordinate and executing national goals at local level.

(QIOs will have flexibility to determine the number of meetings required to get the work done within available resources and time commitment of local partners. It is anticipated that at least three meetings will be needed with at least one face to face meeting and others done virtually)

National Faculty Meetings Comprised of experts in the field as nominated by the statewide QIO efforts, the National Coordinating Centers or other sources. Serves as faculty for the National Learning and Action Network Meetings (Meets three times a year with approximately 100 people for 1 ½ days. Most likely face to face) QIOs should plan to have 1 faculty member attend a meeting 3 times per year.

National Learning Network Meetings (QualityNet Meetings) Travel teams, including providers, QIOs, patients, etc. coming together to hear from faculty and other experts, share learnings, developke action plans that can be taken back to local level for customization.

(Face to face meeting with satellite downlinks for those that remain in the states. Two of the meetings will be sponsored by CMS and one meeting will be left open to append to partners meetings that will allow for a Learning and Action type format. Meetings will likely occur in the Washington/Baltimore area.) QIOS may bring teams up to 15 people that may be responsible;