Project ECHO Uses Collaborative Approach to Improving Quality and Safety

​Project ECHO is an “all teach, all learn community" that brings providers together to collectively treat patients and leverage scarce resources, said Cory Sevin, RN, senior director, Institute of Healthcare Improvement (IHI), speaking on December 13, 2017, at the IHI National Forum in Orlando, Florida. Project ECHO's methods include using technology (e.g., videoconferencing) to connect providers, sharing best practices among organizations, applying case-based learning, and evaluating and monitoring outcomes using web-based systems. An IHI–Project ECHO collaborative seeks to determine whether the Project ECHO model can support quality-improvement education and streamline complex systems. Sevin and Elizabeth Clewett, PhD, MBA, program specialist, Project ECHO, described a test case on improving clinical case flow in 16 federally qualified health centers (FQHCs). Over a 12-month period, team members from each of the 16 centers participated in weekly two-hour teleECHO clinics using videoconferencing software. Each virtual clinic consisted of case presentations from two FQHCs, which included clarifying questions, problem solving, and recommendations, and a didactic component; after the clinic, follow-up recommendations were sent to presenters. Participants also received education in collecting and monitoring quality improvement data. All participating centers saw improvements in areas such as clinical case flow as measured by the third next available appointment, patient and family satisfaction, and rates of colorectal cancer screening. In addition, FQHC providers and staff felt more comfortable measuring and monitoring quality improvement data. After the 12-month period, 10 of the 16 FQHCs continued the project for an additional six months to further refine and improve. Sevin and Clewett recommended that other organizations interested in “virtual telementoring" should create a safe learning culture and have a “theory of change," use templates for each virtual presentation, review data during each virtual session, and build a learning community over time.