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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Overview

Successful use of Health IT enabled Quality Improvement requires a strong organizational foundation. This includes understanding motivating factors as well as barriers, communicating the value of using Health IT to improve quality and outcomes, and building buy in and commitment throughout all levels of the organization. Resources in this section provide ideas and guidance on how to navigate this critical first step.

Prioritization Matrix

Prioritization Matrix

A framework for selecting QI activities or project

What is it and how can it help me?

It is sometimes difficult to know where to start when approaching several opportunities to improve care process that emerge from a quality improvement project. A prioritization matrix is a management tool that uses a simple framework to compare multiple options side-by-side using standard criteria.

 

Download one of the prioritization matrix tools below.

  • One is for selecting a target for a QI Project (e.g., hypertension control, colorectal cancer screening, immunizations, etc.)
  • The other is for selecting among potential improvements identified.
    • These are word documents that you can further edit for your own purposes.

 

Prioritization Matrix for Selecting Target for QI Project

  1. Using the Guide to Improving Care Processes and Outcomes in Health Centers or beginning another QI project, a number of potential targets will be identified (e.g., hypertension control, diabetes control, colorectal cancer screening, no show rate, etc.)
  2. List those potential enhancements in the Opportunities to improve target performance column in this matrix.
  3. Rate each possible target according to the scale provided. You can also leave a column blank if you don’t find it relevant, just be sure to leave it blank for all options.
    1. When rating External requirement consider whether this target metric is related to required reporting, such as UDS, or even more that one reporting requirement? If yes, rate it a 3, otherwise, rate as a 2 for something that is desired or is tangentially related, or a 1 if it is not required for external reporting.
    2. When rating Cost consider how substantial the financial investment would be for addressing the target being considered? If the financial investment is relatively low, then rate it a 3. Rate a 2 if a moderate financial investment would be required, and rate a 1 if the activity would require a substantial financial investment, (i.e., the cost is high).
    3. When rating Difficulty, you may consider whether you currently have the staff, referral relationships, or other key components that are critical to addressing that target. For example, if you do not have an OB/GYN or someone appropriate to conduct pap tests on staff, and you don’t have an existing referral relationship with a provider who completes pap tests in your community, then targeting cervical cancer screening for improvement would be difficult.
    4. When rating Impact, consider how large of an impact addressing the target could have. For example, are there a large number of patients with the condition or in need of the screening? Is current performance particularly low such that a change could result in significant improvement?
  4. Once all potential enhancements are listed and ratings are in each column, add all columns together to identify the items that are likely to have the biggest greatest impact with the most efficiency. Those potential enhancements that have the highest score (=external requirement + cost + difficulty + impact) may be the best enhancements to try first.

 

Prioritization Matrix for Selecting Improvement to Test

  1. Using the Guide to Improving Care Processes and Outcomes in Health Centers or beginning another QI project, a number of potential targets will be identified (e.g., hypertension control, diabetes control, colorectal cancer screening, no show rate, etc.)
  2. List those potential enhancements in the Opportunities to improve target performance column in this matrix.
  3. Rate each possible target according to the scale provided. You can also leave a column blank if you don’t find it relevant, just be sure to leave it blank for all options.
    1. When rating External requirement consider whether this target metric is related to required reporting, such as UDS, or even more that one reporting requirement? If yes, rate it a 3, otherwise, rate as a 2 for something that is desired or is tangentially related, or a 1 if it is not required for external reporting.
    2. When rating Cost consider how substantial the financial investment would be for addressing the target being considered? If the financial investment is relatively low, then rate it a 3. Rate a 2 if a moderate financial investment would be required, and rate a 1 if the activity would require a substantial financial investment, (i.e., the cost is high).
    3. When rating Difficulty, you may consider whether you currently have the staff, referral relationships, or other key components that are critical to addressing that target. For example, if you do not have an OB/GYN or someone appropriate to conduct pap tests on staff, and you don’t have an existing referral relationship with a provider who completes pap tests in your community, then targeting cervical cancer screening for improvement would be difficult.
    4. When rating Impact, consider how large of an impact addressing the target could have. For example, are there a large number of patients with the condition or in need of the screening? Is current performance particularly low such that a change could result in significant improvement?
  4. Once all potential enhancements are listed and ratings are in each column, add all columns together to identify the items that are likely to have the biggest greatest impact with the most efficiency. Those potential enhancements that have the highest score (=external requirement + cost + difficulty + impact) may be the best enhancements to try first.
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Acknowledgements

This resource collection was compiled by the HITEQ Center staff with guidance from HITEQ Advisory Committee members and collaborators of the HITEQ Center.