Vulnerable Populations in the United States by Leiyu Shi & Gregory D. Stevens

Author:Leiyu Shi & Gregory D. Stevens [Shi, Leiyu & Stevens, D. Gregory]
Language: eng
Format: epub
Published: 2021-03-03T00:00:00+00:00

Robert Wood Johnson Foundation's Aligning Forces for Quality Project From 2007 to 2015, the Robert Wood Johnson Foundation (RWJF) ran a community-based health care quality improvement initiative called Aligning Forces for Quality. The idea was to improve the health of Americans by both lifting the quality of health care overall and by targeting at-risk groups. The initiative funded 16 demographically and socioeconomically diverse communities around the country that collectively represented about 37 million people. Grant recipients formed coalitions to coordinate activities in 5 key areas: (a) measurement and reporting of health care quality, (b) engaging patients in their care, (c) spreading the adoption of quality improvement strategies, (d) ensuring equitable delivery of health care, and (e) payment reform. All of the Aligning Forces for Quality program's materials, analyses and results are available on its website.

The communities were diverse in their approaches to improvement, but the initiative reported several key lessons that resonate today (Robert Wood Johnson Foundation, 2015). First, bringing groups representing different stakeholders together, with the right leadership, helped overcome issues of mistrust to achieve better care. The participating community in New Mexico formed a coalition (which eventually became a non-profit that continues today) to create a public-reporting website for health care quality and then launched a campaign to reduce emergency department use. Second, when physician and hospital performance were accurately measured and publicly reported, the quality of care improved. Participating communities in Massachusetts, Minnesota and Wisconsin, for example, worked with Consumer Reports to share cost and performance data for more than 1,000 medical groups with their communities. Third, both patients and employers had key roles to play as partners in improving health care. By engaging patients, the participating community in Detroit, for example, targeted people at risk of cardiovascular disease in an exercise prevention program, leading to a reported 31% improvement in cardiovascular fitness.

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