Core Competencies

THE CHALLENGE: Your state wants to improve quality and safety scores for the bottom quartile of nursing homes in your state.

Ways Convergence can help:

Convene & facilitate stakeholders: 

• Recruit an advisory committee with diverse perspectives (nursing home staff and leaders, ombudsmen, local health agencies, state and local nursing home agencies or associations, patients and family caregivers) to uncover challenges, set goals, and establish priority areas for action. 

• Facilitate quarterly meetings to strengthen understanding across organizations, report on progress, and cultivate collective accountability for outcomes. 

Analytics & sensemaking:

• Combine datasets (such as medical claims, clinical data, survey findings, and area-level demographic and social needs data) to identify the lowest performing nursing homes based on a balanced set of metrics. 

• Use statistical methods to investigate internal and external drivers of poor quality and safety outcomes. 

• Host listening sessions, focus groups, or interviews to gather qualitative information from clinicians, staff, leaders, and patients that support enhanced interpretation of the quantitative data. 

Improvement at scale:

• Host a virtual learning collaborative to build organizational capacity in the science of quality improvement and use PDSA cycles.   

• Promote peer-to-peer learning through highlighting “bright spots” or organizations that are demonstrating progress. 

• Complement the virtual learning collaborative with site visits at high priority facilities. Experienced improvement advisors will deliver customized technical assistance and engage teams in co-designing sustainable solutions. 

• Launch a quality leader mentorship program to increase knowledge and share best practices, especially for leaders that are new in their roles. 

• Create practical tools, templates, and resources to show how to implement evidence-based practices. 

Learning & evaluation:

• Use surveys, interviews, and focus groups to understand what methods are effective and which can be improved 

• Create facility-level reports (such as run charts) to track progress over time. Annotate run charts to identify where a change led to an improvement.   

• Use statistical methods to understand patterns in performance across the cohort. Follow up these findings with qualitative investigation to understand the actions that led to improvement.  

Experience to build on: Hospital Quality Improvement Contract, Cal Long Term Compare

THE CHALLENGE: Your hospital association wants to help hospitals in rural and frontier communities understand the social, economic, and health care needs of their patients.

Ways Convergence can help:

Convene and facilitate stakeholders:

• Engage partners across the state with diverse expertise and perspectives in planning and design sessions. 

• Ensure a structured approach to gathering and incorporating input. 

• Use regular advisory council meetings to build awareness and excitement among partners, which will help to socialize and increase spread of the solution. 

Analytics and sensemaking:

• Design a new social needs index to characterize both health care and socio-economic factors that correlate with life expectancy at birth. 

• Assess the feasibility of various data sources, including medical claims, clinical data, social drivers of health data sets, demographic data sets, geographic indicators and more. 

• Engage advisory council in assessing the utility and relevance of various metrics to understand social and economic needs.   

• Use epidemiological and statistical methods to create reports that show variation within and between communities to highlight opportunities for improvement efforts. 

Improvement at scale:

• Convene health care leaders, social service providers, community based organizations, and more at a community meeting to review data and choose a focus area for improvement.  

• Host a virtual learning collaborative to guide hospitals in implementing an improvement project that addresses social needs highlighted in the data.  

• Create a framework and tools to help hospitals strengthen partnerships with community-based organizations, social service providers, local business, and people with lived experience. 

• Publish case studies and tip sheets based on experience that disseminate lessons learned and recommendations to other facilities. 

Learning & evaluation:

• Employ validation techniques to ensure utility of the social needs index. 

• Systematically collect feedback from all learning sessions to understand which activities most helpful to hospitals.   

Experience to build on: Montana Index for Healthy Communities

THE CHALLENGE: Your accountable care organization wants to offer technical assistance to primary care providers to help them identify and treat substance use disorders.

Ways Convergence can help:

Convening and facilitating stakeholders

• Identify and hold interviews with influential provider, advocacy, and patient groups to uncover barriers and promising solutions. 

• Recruit a small advisory group of influential local leaders (for example from large medical groups, FQHCs, or local rural health associations) to develop priority areas, goals, and commit funding to improvement efforts. 

• Intentionally engage new partners or re-engage those who have been excluded from improvement efforts. 

Analytics and sensemaking

• Mine existing data sources (such as health information exchanges) to identify current indicators of substance use disorder screening, referrals, or treatment (such as buprenorphine prescribing and concurrent naloxone dispensing). 

• Use publicly available data to conduct a preliminary assessment of the state of screening and treatment.  

• Leverage our longstanding collaboration with PFCCpartners to host listening sessions with patients, family caregivers, and people with lived experience. Collect their ideas for how primary care practices can better meet the needs of patient with SUD.    

Improvement at scale

• Deploy an honor roll self-assessment tool to allow organizations to report their processes and practices. Celebrate achievement and improvement through a public recognition program. 

• Facilitate regional virtual improvement collaboratives for primary care practices. Coach practices through using PDSA cycles to increase testing and/or treatment for SUD. 

• Host regional in-person meetings to convene partners, highlight bright spots, and codesign solutions to persistent challenges. 

• Explore the impact of stigma in identifying and treating SUD through innovative learning events that pair clinicians and health care leaders with people with lived experience. 

Learning & evaluation

• Create facility-level reports with monthly data on select process and outcome metrics. Stratify data by demographic categories to support identification and elimination of disparities. 

• Disseminate bright spots in performance and improvement to inspire other practices.  

Experience we can build on: Cal Healthcare Compare Opioid Honor Roll

THE CHALLENGE: As a CMS Learning System contractor, you want to design a learning system that supports awardees in the Transforming Maternity Health Model (TMaH) to achieve improved outcomes for mothers and babies.

Ways Convergence can help:

Convening and facilitating stakeholders 

• Facilitate connections with subject matter experts across the wide range of partners involved in the model, such as the California Maternal Quality Care Collaborative 

Analytics and sensemaking 

• Use national or state datasets to identify “bright spot” communities with outstanding performance, especially in underserved communities and those with high rates of Medicaid beneficiaries  

• Collaborate with community-based organizations, provider organizations, and patients to uncover the specific practices, resources, or systems that enable their high quality and safety scores.  

Improvement at scale 

• Source subject matter experts in topics across the breadth of the model, including hospital quality and safety experts; people with lived experience; midwives, and more. 

• Design engaging and action-oriented virtual events such as shared learning webinars (highlighting bright spots in performance), affinity groups (a regular series focused on one topic), and action groups (multi-session series with facilitated implementation of an improvement project).  

• Produce case studies and tip sheets that highlight and disseminate lessons learned that can accelerate improvement across model participants. 

Learning & evaluation 

• Offer expert insight on trends in performance across the model, for example drawing on our deep knowledge of health care in rural communities or specific challenges at safety net facilities 

• Use feedback mechanisms, such as a needs assessment, post-event surveys, and on-going conversations with model participants to identify opportunities to improve learning events.