Goal 2

Goal 2: To promote excellence and quality through innovation of the Indian health system into an optimally performing organization.

Goal Explanation: In pursuit of high reliability health care services^[9] and care that is free from harm, the IHS has implemented several innovations in health care delivery to advance the population health needs of AI/AN communities. In many cases, innovations are developed to meet health care needs at the local level and subsequently adopted across the Indian health system, as appropriate. The IHS will continue to promote excellence and quality through innovation by building upon existing quality initiatives and integrating appropriate clinical and public health best practices. Recent IHS efforts have been aimed at strengthening the underlying quality foundation of federally operated facilities, standardizing processes, and sharing health care best practices with federal, state, Tribal, and urban Indian programs.

Objective 2.1: Create quality improvement capability at all levels of the organization.

Objective Explanation: Ensure that quality improvement is operational in all direct care, public health, administrative, and management services throughout the system. Quality improvement will be achieved at all levels of the organization, including headquarters, area offices, and service units. Quality improvement methods will be made available to Tribes, Tribal organizations, and UIOs, as requested. Creating quality improvement capability at all levels will require training, resources, commitment, and consistency to assure that every employee shares a role in quality improvement in all IHS operations and services. This objective will build upon efforts of the 2016-2017 IHS Quality Framework^[10] to strengthen quality improvement related to data, training, and standards of care.

Strategies – The following strategies support this objective:

Quality Data:

1. Improve the transparency and the quality of data collected regarding health care services and program outcomes.
2. Develop and integrate quality standards and metrics into governance, management, and operations.
3. Standardize quality metrics across the IHS and use results to identify emerging needs, share information on best practices and performance trends.

Quality Improvement:

4. Provide training, coaching, and mentoring to ensure quality improvement and accountability of staff at all levels of the organization.
5. Evaluate training efforts and staff implementation of improvements, as appropriate.

Standards of Care:

6. Develop and provide standards of care to improve quality and efficiency of health services across the IHS.
7. Adopt the Model for Improvement in all clinical, public health, and administrative activities across the IHS.
8. Adopt patient-centered models of care, including patient centered medical home recognition and care integration.

Objective 2.2: Provide care to better meet the health care needs of American Indian and Alaska Native communities.

Objective Explanation: Key to improving health outcomes and sustaining population health is culturally responsive health care that is patient-centered and community supported. The IHS will implement culturally appropriate and effective clinical and public health tools to improve the health care needs of AI/AN communities. This objective reinforces current efforts addressing culturally appropriate care and supports dissemination of best practices.

Strategies – The following strategies support this objective:

Culturally Appropriate Care:

1. Strengthen culturally competent organizational efforts and reinforce implementation of culturally appropriate and effective care models and programs.
2. Promote and evaluate excellence and quality of care through innovative, culturally appropriate programs.
3. Promote total health integration within a continuum of care that integrates acute, primary, behavioral, and preventive health care.
4. Explore environmental and social determinants of health and trauma-informed care in health care delivery.
5. Continue to develop and implement trauma-informed care models and programs.

Sharing Best Practices:

6. Work collaboratively within the IHS, and among federal, state, Tribal, and urban Indian programs to improve health care by sharing best practices.

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