Patient involvement in CQIs offers clinical care insight

Physicians and surgeons are finding that some of the best information they get to help them improve clinical quality and outcomes comes straight from their patients. In fact, patients and their caregivers add their input by sharing their experiences with providers in six of Blue Cross’ 17 Collaborative Quality Initiatives.

CQIs bring together Michigan hospitals and physicians to address areas of medical and surgical care where there is high cost and high variability, and to identify and share best practices. Participants contribute patient data to a shared registry, then review data and insights with one another several times a year at statewide collaborative-wide meetings.

But merely looking at data doesn’t tell the whole story. Data doesn’t tell doctors how it feels to have a certain procedure, or which side effects are the most challenging for a patient or their caregiver to manage. So when patients actively participate in these CQIs, physicians can incorporate their perspectives into the development of new care processes and protocols.

Incorporating patient input into these CQIs by having patients routinely attend meetings that were previously only attended by physicians has helped inform the direction of the initiatives, ensuring a patient-centered approach to care delivery. Patients have found it equally rewarding to participate and share their experiences with the Michigan provider community.

Michigan Urological Surgery Improvement Collaborative

The Michigan Urological Surgery Improvement Collaborative has involved patient advocates for nearly eight years. Currently, there are 11 patient advocates who provide essential input and feedback based on their condition and the treatment that they have received over the years. The patient advocates provide the voice of the patient, ensure the needs of the patients remain front and center and serve as a compass for the collaborative, according to Tom Leyden, director of Value Partnerships.

“Patient advocates provide feedback about active surveillance for favorable-risk prostate cancer,” Leyden said. “It’s crucial for patients to be actively engaged in shared decision-making to determine which treatment option is best for their prostate cancer care, based on their own preferences, values and goals.”

Bill Crooks, a long-standing MUSIC patient advocate from western Michigan, said, “I feel respected and always get the feeling that my experiences as a prostate cancer patient living with side effects of surgery for more than 25 years are heard.”

Michigan Oncology Quality Consortium

The Michigan Oncology Quality Consortium launched the Patient and Caregiver Quality Oncology Council, known as POQC, in 2017. POQC members guide the selection of quality measures and new projects and provide feedback about their care experience from diagnosis through survivorship. The group makes sure patient input comes from a diverse representation of cancer disease, age, race, ethnicity and gender.

One POQC member said working with the POQC has been rewarding and fulfilling: “We are not only asked for our feedback, feelings and ideas on all that MOQC does, but the message from leadership is respectful, consistent and very public about how important our input is.”

Michigan Bariatric Surgery Collaborative

The Michigan Bariatric Surgery Collaborative includes nine former bariatric surgery patients whose goal is to instill the patient voice and perspective into the work of the collaborative. Members provide input during consortium meeting discussions and panels. Patients share their experiences post-surgery in adapting to their new diet, keeping the weight off, and other challenges that they faced.

“I am humbled to have been asked to provide my unique input into improving the surgical outcomes for all those who have yet to have the procedure,” one of the members said.

Hospital Medicine Safety Consortium

The Hospital Medicine Safety Consortium invited a patient who had multiple complications tied to the use of the commonly used peripherally inserted central catheter, or PICC, line. The patient advocate spoke to the consortium of more than 60 hospitals on why overutilization of PICC lines isn’t always in the best interest of the patient.

“You could hear a pin drop as the patient advocate spoke,” Leyden said. “All eyes were on the patient as she shared her stories of unnecessary complications brought on by overutilization of PICC lines. Bringing the patient voice to the CQI meetings provides information and perspective to the physician community that they may not have been routinely hearing previously.”

This patient also worked with HMS to develop a patient education pamphlet to help future patients understand the role of a PICC line, what other options are available and precautions they can take.

The input from these patients and others is helping the various CQI programs be patient-centered as well as outcomes focused, adding another dimension to the collaborative nature of CQIs.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.