About Care Quality Improvement

The three most critical factors for optimizing a child's potential for early childhood development, intellectual capacity, and lifelong health are: being born on time, at a healthy birthweight, and being breastfed.

An unhealthy environment before and during pregnancy not only raises risks for complications during pregnancy, but sets the stage for health, developmental, and behavioral problems in infancy, childhood, and throughout life.

This Collaborative builds on a national, evidence-based curriculum implemented at the state and national level. The Quality Improvement Framework is built on three theoretical models to achieve the outcomes:

  • The Care Model (see diagram below) describes the elements of optimized care and integrated, client centered services;1
  • The Improvement Model provides a framework for identifying, defining, and measuring incremental changes in practice;2
  • The Breakthrough Series (BTS) Learning Collaborative Model provides the tools and framework for rapid system change.3 The BTS has led to remarkable improvements in the health of individuals living with diabetes, hypertension, asthma, improved child immunization rates, and chlamydia screening among adolescent girls. This framework has been implemented to improve perinatal care in Vermont, and in a pilot program, through the Bureau of Primary Health Care.

care model

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This framework for quality improvement combines the client-centered, community-based, team approach to health care with techniques to make rapid system quality improvement.

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1 Wagner EH. Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice. 1998;1:2-4. www.improvingchroniccare.org
2 Langley GH, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide. San Francisco, CA: Jossey-Bass, 1996.
3 In 1995, the Institute for Healthcare Improvement (IHI) developed a series of collaborative projects called the Breakthrough Series (BTS). BTS is a collaborative improvement method that assists “teams” from health care settings to use quality improvement tools to make rapid system changes that will improve the health of their clients. Specific areas are selected for focused improvement efforts; these represent areas where gaps exists between what occurs in general practice and what is known about “best practices”. “Teams” focusing on implementing the same guidelines work together to share ideas, successes and lessons learned to spread and adapt existing knowledge to multiple, similar sites and accomplish common aims quickly. www.ihi.org