Aligning Forces for Quality is a U.S. national program of the Robert Wood Johnson Foundation aiming to lift the quality of health care in 16 targeted communities, reduce racial and ethnic disparities in those communities and provide models for national reform.[1] Each regional Health care improvement collaborative aims to create sustainable improvements in health care quality throughout its targeted communities by 2015. To do so, the initiative fosters collaboration among multiple stakeholders in a community. Aligning Forces For Quality focuses its efforts on three main areas: Performance measurement and public reporting, consumer engagement, and quality improvement.[2] Aligning Forces for Quality is the single largest philanthropic effort of its kind undertaken to improve the quality of U.S. health care.[3]
The Robert Wood Johnson Foundation launched the first phase of Aligning Forces for Quality in 2007 as an effort to help communities build health care systems where none existed. The first phase provided leadership teams from 14 communities with grants and assistance to help them work with physicians and improve the quality of care, measure and publicly report on the quality of ambulatory care, and enable consumers to make informed health care choices. The program expanded in June 2008 to include a focus on inpatient care, reducing racial and ethnic gaps in care, and enhancing the role of nursing.[4] Since 2007, the initiative has added three additional communities into the alliance, bringing the total number of participating communities to 16.[5] To date, the Robert Wood Johnson Foundation has committed up to $300 million in funding for Aligning Forces for Quality.
Operating primarily on the notion that no single person, group or profession can improve health and health without the support of others, Aligning Forces for Quality seeks to create improvements by aligning key players in local communities. Accordingly, each of the Aligning Forces communities is built around a local leadership alliance, which includes participation from area physicians, nurses, patients, consumers and consumer groups, purchasers, hospitals, health plans, safety net providers and others.
The Aligning Forces for Quality national program office (NPO) oversees and directs assistance to the communities participating in the initiative. These activities are designed to create improvement by engaging teams in participating communities, as well as the broader health care market. Katherine Browne, M.B.A, M.H.A, serves as the interim director/chief operating officer of the NPO, which is located within the Department of Health Policy at The George Washington University School of Public Health and Health Services.[6]
In each community, the Alliances focus on moving quality forward at the local level through activities in three areas of focus:
AF4Q Quality Improvement Networks Hospital Quality Network: Communities in Aligning Forces for Quality are also engaging hospitals in RWJF-funded quality improvement initiatives, aimed at increasing the role of nurses in improving quality, reducing hospital readmissions among cardiac care patients, improving language services for patients who speak little English and increasing the efficiency of hospital emergency departments. Through their participation in one of four collaboratives, hospitals across the communities are increasing the quality, efficiency and equity of their care. These include:
Ambulatory Quality Network: Communities are also part of a peer-learning network that will help them build the infrastructure for ongoing improvement in primary care. The goal is to support communities in developing patient-centered medical homes and implementing and sustaining successful homegrown primary care improvement collaboratives. With expert input and facilitation, the Ambulatory Quality network will bring together local stakeholders to collaborate on improving ambulatory care in their communities, while sharing tools, strategies and lessons learned.[7]
