IPIP Encounter

Improving Performance in Practice (IPIP) is a state-based, nationally-led quality improvement initiative using proven quality improvement methods, technology and data to help physicians redesign and transform their practices. Based on the Chronic Care Model (CCM) and the Patient Centered Medical Home (PCMH), primary care practices give their patients the best possible health care by using a registry or EMR with embedded clinical guidelines to identify and track care for patients with a target condition, running reports to identify patients needing services, and providing self management support including referral to appropriate community services,

The National IPIP began as a pilot in fall 2006 through the innovative leadership of the American Board of Medical Specialties and with funding by the Robert Wood Johnson Foundation (RWJF). Michigan joined the forces in fall 2007 through collaboration of the Michigan Primary Care Consortium (MPCC) with the Automotive Industry Action Group (AIAG) representing the Michigan automotive industry. Michigan's application was strengthened by the state's two Aligning Forces for Quality (AF4Q) programs.

The Michigan IPIP vision was to achieve standardized healthcare goals using tools for quality management and process improvement. The concept was that industry could assist healthcare to improve effectiveness and efficiency through sharing what the Automotives had already done successfully using Quality Management, Process Improvement and other management techniques. The initiative utilized volunteer quality engineers from the automotive sector, trained them in key healthcare concepts, and then assigned them to participating practices to provide coaching on implementation of registries & building a PCMH.

Thirty-three Michigan primary care practices came aboard the project and, assisted by quality engineer coaches and IPIP staff, participated in the following:

• Incorporated National measures/protocols for diabetes or asthma into their practices
• Used quality improvement tools & techniques to drive transformation, standardize care & facilitate improvement
• Participated in monthly, educational learning call-in sessions to further their knowledge
• Attended regional Learning Collaborative programs (three, two-day events) to provide focused opportunities for idea exchange & case studies
• Used decision support tools to build a better models of care (e.g. a visit planner )
• Used or implemented EHR/registries to understand & manage the patient population
• Reported data monthly for national & state-wide aggregation
• Monitored frequently protocol use to track reliability
• Defined self-management support to engage patients in their own care & drive the practice towards the Chronic Care Model

This project has provided insight into the challenges facing practices as they engage in transformation activities. Further, it has demonstrated the impressive gains that can be accomplished using simple quality tools and standardized processes. We now know that the IPIP "process" empowers everyone involved - patients, families, and the health care team. The practice team works together to improve the way preventive services and chronic illness care are provided, guided by the latest and best medical knowledge.