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Research Letter |

Development of a Conceptual Model for Surgical Quality Improvement Collaboratives Facilitating the Implementation and Evaluation of Collaborative Quality Improvement ONLINE FIRST

Michael W. Wandling, MD, MS1,2,3; Christina A. Minami, MD, MS1,2,3; Julie K. Johnson, MSPH, PhD1,2,3; Kevin J. O’Leary, MD, MS1,2,3,4; Anthony D. Yang, MD, MS1,2,3; Jane L. Holl, MD, MPH1,2,3; Karl Y. Bilimoria, MD, MS1,2,3
[+] Author Affiliations
1Illinois Surgical Quality Improvement Collaborative, Chicago
2Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
3Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
4Department of Hospital Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA Surg. Published online September 07, 2016. doi:10.1001/jamasurg.2016.2817
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This literature review examines the creation of a conceptual model of a surgical quality improvement collaborative to facilitate the development, implementation, and systematic evaluation of the Illinois Surgical Quality Improvement Collaborative.

Participation in quality improvement (QI) collaboratives has helped hospitals improve outcomes and decrease costs.1,2 As such, state-level surgical QI collaboratives have become increasingly common. However, the optimal design of an effective collaborative and its key drivers of success remain unclear. Our objective was to create a conceptual model of a surgical QI collaborative to facilitate the development, implementation, and systematic evaluation of the Illinois Surgical Quality Improvement Collaborative (ISQIC).

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Figure.
Conceptual Model of a Surgical Quality Improvement (QI) Collaborative

The overarching influence of the collaborative (purple) is depicted as operating on the hospital, surgical QI team, and perioperative microsystem levels of surgical QI.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Top Down
Posted on September 8, 2016
David Earle
Lowell General Hospital
Conflict of Interest: CMO - Surgical Momentum
It appears from the diagram that the QI leadership doesn't have feedback from the outcomes portion. Additionally, the top down organization shown will eventually impede the function of the team doing the work in favor of cost, specific \"awards\" by alleged quality organizations, and pay for performance models mandated by agencies outside the hospital's control.
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