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The Aligning Forces for Quality initiative: background and evolution from 2005 to 2012.
Dennis P Scanlon1, Jeff Beich, Jeffrey A Alexander
1School of Public Health, University of Michigan, Ann Arbor, MI, USA.
The American Journal of Managed Care
|January 5, 2013
Summary
The Aligning Forces for Quality (AF4Q) initiative, a large community-based quality improvement program, involved 16 alliances addressing key healthcare areas. Implementation varied due to alliance differences despite standardized support.
Area of Science:
- Healthcare quality improvement
- Community-based health initiatives
- Health policy and reform
Background:
- The Robert Wood Johnson Foundation's (RWJF) Aligning Forces for Quality (AF4Q) initiative is a significant, privately funded, community-based quality improvement effort.
- It provided funding and technical assistance (TA) to 16 multi-stakeholder alliances across the United States.
Purpose of the Study:
- To describe the theory of change, evolution, and key activities of the AF4Q initiative.
- To provide an overview of this major multi-site, community-based quality improvement initiative.
Main Methods:
- A qualitative approach was employed.
- Data were gathered through program documents, meetings, observations, and interviews with stakeholders, including RWJF staff, TA providers, and AF4Q alliance members.
Main Results:
- The AF4Q initiative is dynamic, evolving over time and addressing five core programmatic areas.
- These areas include measurement and public reporting of healthcare quality, consumer engagement, adoption of quality improvement strategies, healthcare equity, and integration with payment reform.
Conclusions:
- The AF4Q initiative is ambitious, targeting multiple healthcare system leverage points.
- While alliances made progress, significant variation in program implementation was observed due to differences in alliance composition, market structure, and history.
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