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Collaboratives are links to better care, study says

Researchers say the findings support quality improvement initiatives because with longer follow-up and more patients, better outcomes will be seen. Critics aren't so sure.

By Victoria Stagg Elliott, amednews staff. July 18, 2005.

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Bringing physicians and other health care professionals together in collaborative groups to develop tailored quality improvement strategies might lead to a smoother process of care, but documented reductions in patients' adverse events have yet to be seen, according to a study published in the May/June Annals of Family Medicine.

"Collaboratives work," said Matthias Schonlau, PhD, lead author and head of the statistical consulting service at the nonprofit research organization RAND Corp. "To make that point even stronger, I would want to have that link to the outcomes, but I'm optimistic."

Dr. Schonlau and his team studied a half-dozen medical practices that participated in the Institute for Healthcare Improvement's Breakthrough Series Collaborative for adult asthma care. Teams from the clinics attended three two-day educational sessions and were evaluated for a year.

The findings: Asthmatic patients from these clinics were more likely to attend self-management educational sessions than those at the control clinics. They also were more likely to have a written action plan, to set goals, to monitor peak flow rates and to use long-term asthma medications. Additionally, they were happier with physician communication styles.

"When patients are happier, that's always a good thing," Dr. Schonlau said.

But although providing care was less bumpy, the actual impact on patient health appeared limited. There was no impact on disease knowledge, health-related quality of life or emergency department visits.