Spotlight on quality in Rhode Island.

The theme of this issue is “Collaboration for Quality”. Medical errors have been attracting increasing attention since the Institute of Medicine’s initial publication in 1999. In this issue, Dr. Harry Sax discusses lessons learned from the aviation industry on checklists. Collaboration on checklist development and dissemination has brought these lessons to practitioners throughout the state. Quality tools can aid in navigating the complexity of medical care. Information technology, such as the electronic health record, holds the promise of increasing the efficiency of healthcare delivery, reducing medical errors and improving outcomes through the incorporation of evidence-based guidelines. In this issue, Laura Adams, Chief Executive Officer of the Rhode Island Quality Institute (RIQI) advocates for Rhode Island physicians to become “meaningful users” of information technology which will improve outcomes for patients and financial incentives for the providers. “Collaboration for quality” is the foundation upon which the RIQI was built. Founded in 2001, its mission has been to improve health care quality, safety and value in Rhode Island. It is a collaboration of health care providers, insurers, business leaders, academicians, and government agencies and officials. The fabric of quality in Rhode Island is a complex network with many interlocking threads. Dr. Newell Warde tells of the commitment of the Rhode Island Medical Society to quality health care in RI. He describes the origin of Quality Partners of Rhode Island (QPRI), which had its beginnings under the nurturing support of the Medical Society. Over the years, the efforts and successes of QPRI have led to its recognition as a premier quality organization both statewide and nationally. QPRI is Rhode Island’s Medicare Quality Improvement Organization and a node for the Institute for Healthcare Improvement. The Hospital Association of Rhode Island (HARI) is another pillar of Rhode Island’s quality platform. Founded more than a half century ago, this statewide trade organization assists member hospitals through advocacy, education and services. It has been an important collaborator in implementing evidence-based practices. Through the years, RI’s quality organizations have partnered with hospitals, nursing homes, and outpatient facilities to help providers bring better practices to all Rhode Islanders. At the core of all initiatives, organizations, and partners are individuals, “collaborators for quality,” with a strong commitment to better outcomes in health care. The Rhode Island Intensive Care Unit Collaborative represents one of the most successful collaborations between quality organizations, Intensive Care providers, and health insurers. This Collaborative was introduced in this journal in 2005 and now, in this issue, Dr. Lynn McNicoll and colleagues report on the fruits of this collaboration and outline the benefits. Educational programs have responded in various ways to bridge the gap in performance improvement and quality. Dr. Troncales and colleagues outline their program at the Memorial Hospital of Rhode Island to bring the education of performance improvement processes into the Internal Medicine residency training experience. The program prepares residents with the skills necessary to obtain and implement up-to-date evidence-based knowledge. These articles are but a small example of the “Collaborations for Quality” underway in Rhode Island. On a daily basis, care providers, administrators, health insurers and partners, with the support of Rhode Island’s quality organizations, are working together for safer health care.