Magnan S, Solberg L I, Kottke T E, Nelson A F, Amundson G M, Richards S, Reed M K
Blue Cross and Blue Shield of Minnesota and Blue Plus, St Paul 55164-0179, USA.
Jt Comm J Qual Improv. 1998 Oct;24(10):566-78. doi: 10.1016/s1070-3241(16)30404-7.
The original collaborative project was described in a 1995 Journal article titled "Competing HMOs Collaborate to Improve Preventive Services." IMPROVE (IMproving PRevention through Organization, Vision, and Empowerment) was a large randomized controlled trial using continuous quality improvement to implement clinical systems to improve the delivery of adult preventive services in primary care settings. The project was funded by the Agency for Health Care Policy and Research and initiated as a collaboration between two health maintenance organizations (HMOs) in the Twin Cities: Health Partners and Blue Plus.
Forty-four clinics were recruited for the study. Initially the 22 intervention clinics received the multifaceted intervention of leadership support, training on CQI and prevention systems, and consultation and networking opportunities. Next, the comparison clinics received similar assistance, and other clinics were invited into the collaboration. Ultimately, 57 clinics were involved in the project. Multiple collaborations--among clinics, leaders, and HMOs--developed during the project.
Despite turmoil in the environment during the project, many benefits have been described, including enhanced leadership, growth of systems thinking, better change management skills, and collaboration of competing organizations.
The IMPROVE collaboration survived and flourished in a very competitive market. It was viewed positively by clinicians, medical clinics, and HMOs, and its benefits have extended into the community.
最初的合作项目在1995年发表于《期刊》的一篇题为《相互竞争的健康维护组织合作改善预防服务》的文章中有所描述。IMPROVE（通过组织、愿景和赋权改善预防）是一项大型随机对照试验，采用持续质量改进来实施临床系统，以改善初级保健机构中成人预防服务的提供。该项目由医疗保健政策与研究机构资助，由双城的两个健康维护组织（HMO）——健康伙伴和蓝加号——合作发起。
该研究招募了44家诊所。最初，22家干预诊所接受了多方面的干预，包括领导支持、CQI和预防系统培训以及咨询和建立网络的机会。接下来，对照诊所也获得了类似的帮助，其他诊所也被邀请加入合作。最终，57家诊所参与了该项目。在项目期间，诊所、领导人和HMO之间形成了多次合作。
尽管项目期间环境动荡，但已描述了许多益处，包括领导力增强、系统思维的发展、更好的变革管理技能以及相互竞争的组织之间的合作。
IMPROVE合作在竞争激烈的市场中得以存续并蓬勃发展。它受到了临床医生、医疗诊所和HMO的积极评价，其益处已延伸至社区。
