Cheryl Modica, Director at the Quality Center at the National Association of Community Health Centers (NACHC), was in a typical, but unenviable, position. She wanted to train a lot of people in quality improvement, but she didn’t have unlimited funds to do it.
“We thought a lot about how we could get our resources to go further,” Modica says. “That’s when we made the decision to try the Open School.”
The IHI Open School, part of the Institute for Healthcare Improvement, is a global learning community that includes more than 30 self-paced online courses that teach the basics of quality, safety, leadership, and population health. For 10 years, the IHI Open School has provided students, residents, and health care professionals with the basic skills and knowledge to improve health and health care around the world. All told, learners have completed more than 4 million courses in that time.
“I think it’s wonderful,” Modica says. “Particularly for those early-to-mid-career professionals, the Open School courses provide the skills and knowledge they need to coach improvement at health centers.”
Improvement coaches within state and regional primary care associations (PCAs) and health center controlled networks (HCCNs) are the primary beneficiaries of the training right now. Modica and other leaders within NACHC’s Quality Center provide a national infrastructure for PCA/HCCN QI coaches that work with health centers in all 50 states. For two years, NACHC has offered these QI coaches the opportunity to take IHI Open School courses to fill gaps in their improvement knowledge.
“It’s a beautiful pairing,” says Modica, a nurse by training and who has been working in health center system design and transformation since 1990. “If a coach says, ‘I don’t understand a concept like PDSA or I need to brush up on the Model for Improvement,’ they can go into the Open School. They can walk through the training and strengthen their skills.”
The ability to reach a wide audience was critical for Modica. NACHC supports state and regional coaches to do their work with nearly 1,400 organizations providing care at more than 11,000 sites around the country. To support the work of health system transformation, NACHC’s Quality Center has developed the Value Transformation Framework, a conceptual model that gathers and organizes evidence-based practices to transform a health center’s infrastructure, people, and care delivery systems toward the goals of the Quadruple Aim — a spin-off of the IHI Triple Aim (care experience, population health, lower cost) that includes joy in work.
The Quality Center serves as an umbrella for quality initiatives across NACHC. The Center developed a 15-item assessment tool that QI coaches can use to assess their own skills and knowledge. The tool allows individual users to identify skill gaps that can be addressed through IHI Open School courses or other training. It also identifies training needs at the regional and national level.
The Center has applied QI thinking in the way it implemented its training program by starting small and scaling up.
“In 2016, we offered the Open School to a few individuals,” Modica says. “After we built our assessment tool, we got 100 licenses. And we just bought more licenses for this year.”
In the coming years, she says, the plan is to extend even further, offering the Open School licenses to improvement leaders on the ground within the health centers.
“The foundational courses will be extremely valuable to center QI staff,” she says.
Modica has found that the IHI Open School Dashboard, available with a group subscription, has been one of the key benefits. As an administrator, she gets a monthly dashboard showing use, including courses completed, assessment scores, and continuing education credits earned.
“I have found great value in our group subscription to the Open School, and share that experience as part of trainings to PCA and health center staff and leaders,” she says. “I tell them the Open School is a good place to put some training resources that can impact a lot of staff.”