Organizational Readiness

1. Leadership support is critical for QI efforts to be successful. Health center leaders can provide protected time and resources (e.g., staffing, funding for training, communication channels) for QI implementation.
2. Leadership can integrate ASRH into the health center’s vision, mission, or strategic plan and communicate the importance of the QI initiative to all staff in other ways (e.g., via staff meetings).
3. Underscoring how quality ASRH services align with the health center’s mission can help to secure buy-in from senior leaders and boards of directors.
4. Using local data to demonstrate the need for ASRH services can help build leadership support.
5. As QI efforts get underway, providing regular updates on key milestones, successes, and challenges can ensure ongoing support.
6. Leaders can identify key steps to support improvement efforts using NACHC’s Value Transformation Framework.
7. This Q4T companion slide deck and elevator pitch can be used to engage health center leadership in ASRH QI. This Q4T article discusses how a health center board can support ASRH services through governance-level functions.

1. A clinical champion for quality ASRH care can help to engage leadership and ideally identify an executive champion who can facilitate approval for practice changes.
2. If a clinical champion does not yet exist, leaders can help to identify an individual who is given dedicated time for QI efforts and can lead the improvement team (i.e., core group of staff involved in implementing the QI initiative).

1. To facilitate system-wide change, staff from all organizational levels can be part of the improvement team, including administrators, care team members, and staff from the front desk/call-center as well as health informatics, finance, and QI departments.
2. Regular meetings, scheduled well in advance, with the improvement team can keep QI efforts on track and ensure accountability.
3. The Institute for Healthcare Improvement offers guidance on forming a team.

1. To prepare for ASRH QI efforts, the improvement team may want to review common QI implementation models and techniques. Such techniques may include process mapping, i.e., creating a visual model of a process’s current and future states that include flows, connections, and activities, or co-design, whereby patients contribute to the development and implementation of QI interventions. The Supplemental Tools/Resources section provides common QI models and techniques to consider including process mapping and co-design.

1. Performance measures can be used to monitor progress toward and success in achieving ASRH QI improvement goals.
2. The Supplemental Tools/Resources section provides example performance measures the improvement team can consider adopting.

1. Implementation of some change strategies in Q4T may require new or updated clinical and data workflows. These new workflows will need to be aligned with Electronic Health Records (EHR) to support implementation, performance measurement, and ensure payment.
2. In addition to including a staff member with health informatics expertise on the improvement team to support this work, engaging the health center’s Health Center Controlled Network (HCCN) may also be helpful.
3. This Q4T companion guide offers 8 actions for stronger informatics systems to capture ASRH data needed for QI initiatives.

Answer the following questions about your organization. Before moving forward with your QI initiative you will want to ensure that you can answer “YES” to each question.