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Volume 30 (2)

Volume 30, Issue 2, Spring 2010line
J Contin Educ Health Prof 2010; 30(2)
ORIGINAL RESEARCH

Practice Transformation: Use of Manufacturing Quality Experts in the Primary-Care Office
Rose M. Steiner, David T. Walsworth

A b s t r a c t

Introduction: Improving Performance in Practice (IPIP) is an initiative convened by the American Board of Medical Specialties, and is investigating the efficacy of coaches in helping primary-care practices improve the care of patients with diabetes and asthma. Most IPIP states use coaches who have a health care background, and are trained in quality and process improvement. Michigan uses quality experts from the manufacturing industry who are educated regarding the health care environment, which enables them to perform as quality-improvement coaches (QICs) in primary-care practices.
Methods: Ninety-six quality experts were trained to coach primary-care practices in this case study, with 53 currently assigned to offices, and others assisting as needed. Practice teams and QICs identify gaps in care and office practices with the use of assorted quality-improvement tools. Reports are made monthly to describe clinical and process measures and methods used.
Results: Michigan has 33 practices engaged, involving 205 physicians and 40 midlevel providers. The teaming of quality experts from the manufacturing industry with primary-care office providers and staff resulted in office efficiency, improved care provided, and progress toward attainment of a patient-centered medical home (PCMH).
Discussion: Quality experts from manufacturing volunteered to coach for improvements in primary care. The efforts of QICs have been successful. Because the QICs are volunteers, sustainability of the Michigan Improving Performance in Practice program is a challenge.

Lessons for Practice
  • Use of quality tools used in the manufacturing industry can have a positive impact on transformation of a primary-care practice.
  • Quality-improvement coaches can help physicians and their staff to learn qualityimprovement tools and apply them effectively in practice to improve the care of chronically ill patients.
  • Utilization of volunteer coaches who hold another job limits the time and focus they have with the practice
  • A model should be developed that makes quality experts available to implement change and to sustain gains in primary care.
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