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A Nationwide Program for Improving Quality & Safety

Throughout the United States, efforts are being made to improve the overall quality of healthcare, reduce racial and ethnic disparities, and provide models for national reform. One such effort is the Aligning Forces for Quality (AF4Q) program. Supported by the Robert Wood Johnson Foundation, the AF4Q program brought together hospitals in 16 geographically, demographically, and economically diverse communities that together cover 12.5% of the U.S. population. Ranging from major metropolitan areas to a Northern California county of 260,000 people, each community partaking in the program makes concerted efforts to address public reporting of quality, patient engagement in care decisions, and physician payment. Each of the 16 communities participated in the AF4Q Hospital Quality Network (HQN). Teams at participating hospitals came together for learning sessions via webinars to identify where problems existed and how they had been addressed. According to Robert Graham, MD, two of the areas focused on for the HQN program were reducing readmissions and improving language services. Catherine A. West, MS, RN, adds that process and outcomes measures were collected and reported monthly to the AF4Q National Program Office at George Washington University. Reducing Hospital Readmissions “The AF4Q program focused strongly on readmissions among patients with congestive heart failure because of their high risk for being readmitted,” says Dr. Graham. “Across the board, participating hospitals achieved the most success with early identification of these patients and participation in transitions programs [Table 1]. These programs allow for patients to know—as they’re discharged—exactly what they need to do, what has changed, why it’s changed, and how to link with physicians in the community. The key is to ensure that...
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