全球智库信息集成服务系统

Leadership Facilitates Implementation

• Strong leaders successfully oversaw the implementation of cultural and process changes while ensuring that patient needs guided their efforts.

A Dedicated Team Is Essential

• A team spanning multiple disciplines, including senior staff, and working to secure staff buy-in for proposed changes can guide the effort to a successful result.
• Staff shortages limited the ability to expand access and use empanelment and multidisciplinary care teams. A dedicated implementation team that provides consistent messaging can help maintain forward progress.

Consistent Communication Can Secure Buy-In

• Engaging staff, sharing data, and communicating successes can encourage staff to pursue continuous process improvements.
• Working with tribal leaders and the community can secure buy-in for major changes, leverage community assets, and build trust.

Program Tools Are Valuable

• The IPC tools were appreciated, but support from IHS Area Offices varied. Some clinics reported that their area-level improvement support teams were not able to consistently provide the level of assistance needed.

Assessing Needs Focuses Efforts

• Knowing a clinic's population was essential in meeting their needs.
• Analyzing clinic expenditures and other providers' availability could determine ways to spend resources more efficiently.

Smaller Clinics May Need More Assistance

• Smaller clinics suffered disproportionately from staff turnover, reported a limited ability to apply for grants, and described shortages of staff with expertise in quality improvement, data analytics, or use of the iCare system.

Third-Party Revenue Is Critical

• Additional revenue, particularly from Medicaid reimbursements, helped clinics hire more staff, expand access, and invest in improvements.

The Overall Impact Is Positive

• The clinics reported positive feedback from staff, high performance on quality measures, and improvements in patient satisfaction and access to care.