An 'Infusion of Resources' Gets the Quality Ball Rolling

When it comes to getting the word out about consumer products, Procter & Gamble (P&G) has etched into the American lexicon everything from Charmin® toilet paper and Crest® toothpaste to Vicks® cough drops. So when a collaborative of business leaders and medical care providers in the conglomerate’s hometown of Cincinnati went looking for ways to tap into what people understood about health care and the ABCs of quality diabetes treatment, they turned to a P&G brand specialist. “We found people really didn’t know about the standards of diabetes care,” says Judy Hirsh, a Procter & Gamble marketing manager. Hirsh was tapped by the Health Collaborative, which manages Cincinnati’s Aligning Forces for Quality (AF4Q) grant, to help spearhead a physician quality reporting initiative.

The organization settled on diabetes because of the heavy disease burden and because strong, nationally-recognized quality measures exist for the condition. Hirsh did what Procter & Gamble does with its giant consumer products business by holding focus groups. But this time, the focus was people with diabetes. “There were people who said, ‘What’s an A1c?’ or ‘My doctor has never looked at my feet.’ There was a huge need to communicate the standards and to empower people, so when someone goes into the doctor’s office they know, ‘This is what the doctor should be doing for me because I have diabetes, and if my doctor doesn’t take an A1c, I should be smart enough to know that I can ask for one.’”

Sometimes all it takes is a little push to get the ball rolling. In Greater Cincinnati, the proverbial ball is primary care practice transformation, and the nudge came from Aligning Forces for Quality. Before receiving a $3 million grant from the Robert Wood Johnson Foundation’s Aligning Forces initiative in 2007, the area already had an active health care community—but its efforts weren’t systematic, says Craig Brammer, CEO of the Health Collaborative, which represents Cincinnati health care providers, payers, employers, and consumers. Past initiatives were smaller projects, such as flu shot or mental health awareness campaigns. The Health Collaborative first focused on creating a system for publicly reporting physician performance on diabetes measures and then expanded its efforts to include fostering the creation of patient-centered medical homes. Today, about 600 Cincinnati-area primary care physicians are reporting diabetes measures on a public website and more than 130 practices are certified patient-centered medical homes.