{"id":2885,"date":"2026-09-02T14:27:56","date_gmt":"2026-09-02T21:27:56","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=2885"},"modified":"2026-09-02T14:27:56","modified_gmt":"2026-09-02T21:27:56","slug":"engagement-a-key-strategy-for-improving-quality","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=2885","title":{"rendered":"Engagement: A Key Strategy for Improving Quality"},"content":{"rendered":"

By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer<\/strong><\/p>\n

\n

\u201cNever underestimate the empowering effect of human connection.\u201d<\/strong><\/h1>\n

– Drishti Bablani, philanthropist and author<\/em><\/p><\/blockquote>\n

Before 2019, Partnership focused on using our pay-for-performance programs (Quality Incentive Programs, or QIPs) to encourage primary care clinicians and other providers to focus on improving quality within their practice. Many of our providers closely watch the QIPs and respond to them. However, we noted that \u2013 for many reasons \u2013 for some providers, the pay-for-performance approach was not effective at driving improved quality. One hypothesis was that the providers did not know how to improve quality, so the performance improvement team offered a variety of educational programming and toolkits to help. Again, some providers leveraged this information, but others would not. We determined then that a key factor missing from low-performing sites was leadership and management engagement, and prioritization of quality improvement activities.<\/p>\n

This led to a new strategy over the past several years of using leadership and management engagement as a strategy<\/strong> for focusing the attention and resources needed to move the dial on quality within their organization. Here is a summary of the engagement activities:<\/p>\n

    \n
  1. Annual Regional Meetings with Clinical Leaders<\/u><\/strong>: These meetings started in 2014 and continue currently. In 2026 these meetings were held in seven locations throughout our service area, with over 100 clinical leaders attending, mostly from primary care practices. A subset of highly engaged leaders who attend bring the information back to their health centers, making changes to improve quality.<\/li>\n
  2. Joint Leadership Initiative (JLI)<\/u><\/strong>: This initiative started in 2019, focusing on 10 large primary care providers with medium or low PCP QIP scores. Senior leaders at Partnership meet two-four times a year with senior leaders of the primary care organizations to focus energy and attention on quality improvement. In the history of the program, five programs have graduated \u2013 due to high performance achievement \u2013 and four new organizations were added at the time of the 10-county geographic expansion. While improvement was not universal, it was very successful for several organizations; this program continues currently.<\/li>\n
  3. Tribal Health Center Engagement<\/u><\/strong>: In 2020, when Partnership separated quality measures by race and ethnicity, we found that the American Indian\/Alaska Native category had worse outcomes than all other race\/ethnicity categories. Diving deeper, we found that the dollars offered for the PCP QIP represented a smaller percentage of financial incentive for Tribal health centers, compared to other PCPs. Furthermore, since Tribal health centers are governed by autonomous Tribal nations, there is no state of federal requirement to deliver better quality, as measured by our Healthcare Effective Data Information Set (HEDIS) metrics. Finally, there is a strong distrust of the motivations of governmental organizations that are not Tribally affiliated, based on a history of broken treaties, efforts at cultural erasure, and a lack of understanding by outsiders on Tribal priorities and processes of decision-making. In 2022, we launched a portfolio of Tribal engagement activities to support better health outcomes for our Tribal members, including designating a Partnership Tribal liaison, leadership visits with individual Tribal health centers, and an annual Partnership Tribal health convening (the 4th annual convening will be held this October in Chico). Quality outcomes are improving in most Tribal health centers, although a few of the health centers still struggle. Financial pressures, leadership turnover, and differing priorities of board and senior leaders are common factors for the challenges these sites face.<\/li>\n
  4. Enhanced Provider Engagement (EPE)<\/u><\/strong>: Building on the success of the JLI concept, starting in 2024 we began a more intensive engagement program, which includes smaller, low-performing primary care organizations. Additions include a requirement to give a presentation to their governing body (to model and encourage the leaders on the governing board to monitor quality more closely), and to work with assigned performance improvement coaches, which directs their efforts on a smaller group of measures to help focus their activities. The performance improvement advisor team grew and regionalized to meet this need. Some smaller providers have made good progress on improvement, while others have not been as successful.<\/li>\n
  5. Partnership Clinic Leadership Academy<\/u><\/strong>: The importance of strong leadership on both the clinical and non-clinical sides of healthcare organizations has been recognized in California since just after 2000. At one time, there were five different leadership training programs being funded by foundations. Over time, several programs have closed or lost funding. With turnover, many of the leaders who trained in the 2000s have retired or moved on, so the current cadre of leaders have little formal leadership training. In response to this, Partnership launched the Clinic Leadership Academy in 2026, in which 34 emerging leaders participate in a strong leadership training program, with programmatic support of HealthForce UCSF. This first group will graduate in 2027. One unique aspect of Partnership\u2019s version of this leadership training is a more intensive inclusion of quality improvement and performance improvement methodology in the entire curriculum. As a side benefit of Partnership running the leadership training, Partnership leaders are using the program to build relationships with these emerging leaders. Thus, it is another engagement strategy.<\/li>\n
  6. Wider Community Engagement<\/u><\/strong>: Partnership\u2019s very name evokes the importance of working with others in the community to optimize our healthcare delivery system. The 2024-2027 Strategic Plan<\/a> includes a strategy: \u201cChampion Local Partnerships, Provide Statewide Leadership.\u201d This requires engagement with many community partners, in addition to our provider network. This community engagement builds trust and relationships, which makes our provider network more amenable to engagement efforts focused on quality.<\/li>\n<\/ol>\n

    Engagement of our provider network, coupled with pay for performance incentives and robust educational offerings, is a sustainable strategy for building lasting improvements in outcomes for the vulnerable community members that Partnership serves. The ability to leverage engagement represents a key advantage of a County Organized Health System versus a commercial health plan or the centralized administration of Medi-Cal at the Department of Health Care Services level.<\/p>\n

    Just as engagement is a key strategy for Partnership, it also applies within the clinical setting. Clinical leaders who ensure they have structured time to engage with their frontline clinicians in staff meetings or one-on-one meetings can use this time to focus attention on organizational priorities (like quality improvement) and meeting the needs of clinicians to reduce turnover. Taking time to walk around your health center toward the end of the day or at lunch to check in with your team is a great way to start!<\/p>\n","protected":false},"excerpt":{"rendered":"

    By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer \u201cNever underestimate the empowering effect of human connection.\u201d – Drishti Bablani, philanthropist and author Before 2019, Partnership focused on using our pay-for-performance programs (Quality Incentive Programs, or QIPs) to encourage … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[1],"tags":[],"class_list":["post-2885","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nEngagement: A Key Strategy for Improving Quality - PHC Primary Care Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/phcprimarycare.org\/?p=2885\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Engagement: A Key Strategy for Improving Quality - PHC Primary Care Blog\" \/>\n<meta property=\"og:description\" content=\"By Robert L. 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