QI Microsystems Meeting – Jönköping Academy

Below is a piece written by Jackie Wang, a HealthCorps Navigator at the Community Health Center, Inc. serving in Quality Improvement. She recently took part in a Microsystems Meeting put on by CHC’s Quality Improvement department which featured representatives from Jönköping Academy in Sweden.

     In the face of great challenges, people come together. Survivors and supporters wear pink to promote breast cancer awareness every October; Connecticut leaders and citizens gathered last week to discuss how to eliminate health disparity in the state at the Health Justice Town Hall; Americans everywhere are coming together to recover in the wake of Hurricane Sandy. CHC has participated in all of these efforts while facing an additional challenge: how can we provide the highest quality care to an underserved and often uninsured patient population? We have made great strides on our own, but forging new partnerships is a crucial step as we move forward. This month, CHC set the stage for future collaboration with two groups: Sheffield Teaching Hospitals and The Jönköping Academy for Improvement of Health and Welfare.

     Our second set of visitors joined us from Jönköping, Sweden, a county that has invested heavily in quality work and that, consequently, has become a clear leader in health care system performance – not only in Sweden, but also worldwide. They’ve increased the rates of flu vaccination in the elderly citizens of Jönköping, achieved “advanced access” (people are guaranteed a primary care appointment within 1-3 days, a specialist appointment within 2 weeks), reduced the use of antibiotics to combat the spread of antibiotic resistance, and more.

      Furthermore, they’re clearly dedicated to their work! Our guests – Drs. Boel Andersson Gäre, Hans Lingfors, Marie Golsäter, Sven Engström, Mats Nilsson, and Anders Tengblad – arrived at CHC on Monday morning, right in the middle of Hurricane Sandy. Despite some setbacks from the weather, both Americans and Swedes managed to enjoy themselves during two days of discussion, mutual learning, and lots of fika (coffee breaks)!

A few salient themes emerged throughout the visit:

1. The importance of aligning top-down and bottom-up efforts.

     Jönköping Academy and CHC have taken similar approaches to improvement work: providing top-down guidance and support, but placing equal – if not greater – emphasis on driving change at the Microsystem level. Above all, people at all levels of the system need to be engaged in the common goal of improving the quality of care.

1. The relationship between research and quality improvement work.

     How are these two efforts related? How can they complement each other? The publication of a QI project’s results provides peer-reviewed validation of the work, but also forces us to be more rigorous in our thinking and design. In turn, evidence from the literature can help inform our own quality improvement projects. Ultimately, practice-based learning (aka improvement work) and research can and should work together in synergy, each informing and supporting the other. Both organizations are still exploring this relationship.

1. What parallels can we find among our organizations?

     Finally, it was clear that both sides were interested in exploring our common ground. We operate in vastly different health care systems, and thus have some priorities and challenges that don’t neatly align. However, I think Dr. Andersson Gare said it best: we are both “value-based” organizations, driven by the simple desire to make things better. This philosophy – and the great challenge that it entails – translates across even national boundaries.

     This visit was merely an early step in a rewarding partnership; I am excited to see what Jönköping Academy and CHC are able to achieve together. Many thanks to our Swedish guests and to all of our CHC staff who were able to join us despite the hurricane! And I couldn’t end this post without acknowledging the pain and damage that the storm has caused. Best wishes to the people of Connecticut who were affected by Sandy.

 Additional information about the Jönköping Academy visit at CHC can be found on our Facebook account!