CPX Domains: Clinical Quality and Safety

How can health systems continue to provide high-quality clinical services, achieve superior performance, and obtain information necessary to implement sustainable improvement?

AMGA’s Collaborative for Performance Excellence (CPXTM) answers these challenges by offering Clinical Quality and Safety as one of its four domains. The collaborative builds on AMGA’s strong track record of working with members to improve care and quality performance through benchmarking:

  • Our national Together 2 Goal® campaign has improved care for more than 1,000,000 people with type 2 diabetes in its first three years
  • Our Adult Immunization Best Practices Learning Collaborative led to more than 4 million vaccines being administered or by participating groups

In the CPXTM collaborative we facilitate shared learning across the collaborative, empowering groups with overall high performance to share how they are accomplishing their success. Participants may also be matched up with organizations based on a myriad of data points, so that both organizations can learn from one another what methods are working to move the needle, and also which methods aren’t working, to shorten the learning curve, enabling groups to drive change more efficiently and effectively.

Domain Measures

CPXTM participants will receive the following measures:

  • Colorectal cancer screening
  • Breast cancer screening
  • HbA1c control
  • Hypertension/high blood pressure control

See our benchmarks in action

The power of data and advanced analytics enable collaborative participants to:

  • Achieve superior population clinical outcomes efficiently and cost-effectively
  • Identify and act to improve low-performance areas
  • Incorporate insights quickly into practice workflows
  • Benchmark against peers, with opportunity for peer-to peer learning from top performers

Figure 1 – Colorectal Cancer Screening Benchmark – Screening Type

Colorectal Cancer Screening Benchmark – Screening Type

Colorectal cancer (CRC) is one of the most common and treatable forms of cancer, and early detection is key to successful treatment and saving lives. This is a remarkable moment in our centuries-long effort to reduce the burden of cancer. Cancer mortality rates are falling, yet, we are still missing far too many opportunities to save lives through CRC screening. Which is why we have CRC screening as one of our most utilized measures in the Clinical Quality and Safety domain.

Figure 1 shows sample CRC screening rates for the last measurement year of 22 CPXTM participant organizations with data available. The wide bar on the left shows that overall, 61% of eligible patients were screened; 47% by colonoscopy, 6% by flexible sigmoidoscopy, 5% by fecal occult blood tests (FOBT) or fecal immunochemical tests (FIT), and a small percent of patients via FIT-DNA (Cologuard®) or CT colonography (“virtual colonoscopy”). Across individual organizations, Figure 1 shows CRC screening rates ranged from 48% to 82%, reflecting variation in performance, in addition to variation in the tests used.

Figure 2 – Colorectal Cancer Screening Performance Over Time

Colorectal Cancer Screening Performance Over Time

Figure 2 displays an interactive dashboard that is available to each participant in the Collaborative. In the left box, each circle represents one organization, and the size of the circle reflects the number of patients eligible for CRC screening. The vertical axis shows current CRC screening performance, and the horizontal axis, change in performance from the previous year.

The box on the right is similar, where each square represents a site of care from a Collaborative participant. When a user logs in to the interactive portal, sites of care from their organization are highlighted in red. While there is some variation in screening rates across organizations, there is much wider variation across sites of care, and more importantly, each organization has sites of care that are among the highest and lowest performers. Participants can use this data to identify high-performing or rapidly improving sites at their own organization, understand what they’re doing differently, and introduce across their group or system.

* Data source: Optum, AMGA’s Distinguished Data and Analytics Collaborator