Quality Improvement Case Study: Cool Springs Internal Medicine & Pediatrics

With health care transitioning from fee-for-service to value-based care, quality measures have become a focal point for providers and insurers to gauge quality of care. However, many practices find the process of tracking each quality measure to be overwhelming to staff. Each payor may have unique requirements, causing staff members to juggle different performance measures and coding best practices. Without a tried-and-true quality process in place, some practices can potentially jeopardize their opportunity to earn shared savings.

At Cool Springs Internal Medicine and Pediatrics (CSIMP), staff members recognized the changing healthcare landscape early on, prioritizing operational changes to their quality improvement process. These changes have allowed them to stay ahead of the curve and consistently meet the different measures set by multiple payors.

This Middle Tennessee-based multi-specialty practice has 50 team members who provide care to 3,000 patients per month. They have exceeded quality measure targets every year since 2016, the same year they hired a clinical quality coordinator to oversee quality measure performance. By focusing on training, communication and quality measure awareness, the clinical quality coordinator was able to create a culture that embraced constant changes in payment models.

Establishing a team-based approach to care and encouraging participation from each team member have been critical to CSIMP’s success. Every new hire at CSIMP works with the coordinator to learn how their position impacts the quality measures process. The practice provides training on effective documentation and coding as well as guidance on transitions of care and medication reconciliation.

The practice also formed a quality measures team made up of a clinical quality coordinator, office manager and clinical provider that meets weekly to streamline the quality measure process. CSIMP encourages team members to ask questions and provides recommendations to approach quality measures holistically in order to meet performance measures and improve individualized care.

CSIMP also collaborates with VHAN’s interdisciplinary team and leverages network quality resources from the VHAN Hub. Download the Quality Measures toolkit to get started on your own quality improvement process in 2021.

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