Pittsburgh Regional Health Care Initiative (PRHI) is a consortium of businesses, hospitals, insurers, and organizations that provide health care services to people in western Pennsylvania. High costs and poor comparative quality resulted in the formation of the PRHI in 1997. The model is based on identifying and analyzing causes of the problems at the point of care, involvement of frontline workers in identifying solutions, and encouraging change based on shared learning (11,12). PRHI focused on improving clinical outcomes in patients undergoing coronary artery bypass graft surgery, those with depression or diabetes, for maternal and child care, and for hip and knee surgeries. In addition, medication errors and nosocomial infections were addressed. The project created a shared database between the participating health care organizations to collect data on processes of care and link outcomes to them. The information and outcomes of successful processes are then shared with frontline workers, so that they can provide appropriate care.The goal is to develop a system of care with real-time feedback and to connect processes to outcomes for continuous improvement in quality. Significant improvements in nosocomial infections and medication error reporting have been achieved.
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