Related Experiment Video
Updated: Aug 6, 2026
The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Implementing Quality Improvement Projects Across A Large Integrated Health Care System: Lessons from an ABMS
Megan Sprague1, Sean Powell, Sarah Shimer
1Ms. Sprague: Learning Consultant IV, KP National CME Program, The Permanente Federation, Oakland, CA. Dr. Powell: Medical Director, KP National CME Program, The Permanente Federation, Oakland, CA. Ms. Shimer: Sr Manager, KP National CME Program & Garfield Memorial Fund, The Permanente Federation, Oakland, CA. Dr. Robbins: Medical Director, Clinical Information Services & Education, The Permanente Federation, Oakland, CA. Dr. Cain: Executive Director, Clinical Information Services & Education, The Permanente Federation, Oakland, CA.
Introduction:
Kaiser Permanente's National Quality Improvement (QI) Continuing Certification/Maintenance of Certification Program, an American Board of Medical Specialties Portfolio Program Sponsor, engages physicians in clinical improvement through organization-specific QI projects that fulfill continuing certification/maintenance of certification requirements. This study describes the program's structure, project development, and design choices that increase physician participation and organization-wide impact, and how this structure is applicable to many different types and sizes of health care organizations.
Methods:
The program integrates national and regional leadership, with projects originating from grassroots (local leaders) and executive (national initiatives) levels. Data were collected through physician self-attestations on outcomes and reflections, aggregated and analyzed quantitatively and qualitatively at multiple levels. Case studies illustrate key success factors.
Results:
Over 13 years, 7145 physicians have completed projects, with 88% meeting improvement thresholds. In 2024, 375 physicians engaged in 42 different projects, with 85% achieving at least one project goal. Case studies of grassroots and executive projects showed comparable clinical improvements, with 94% and 86% achievement rates, respectively.
Discussion:
Engaging physicians in synergistic projects that support organizational priorities increases the impact of individual contributions. Flexibility in design and collaboration between regional and national teams are critical to effectively drive physician engagement and improvement. Supporting both grassroots and executive level QI projects allows for tailored interventions and broad alignment, enhancing physician participation and patient care.
Related Concept Videos
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:20Integrated Healthcare System
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...