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Abstract Details

Two-Year Interim Results of the MS-CQI Research Collaborative
Multiple Sclerosis
P16 - Poster Session 16 (5:30 PM-6:30 PM)
9-014

MSCQI aims to: (1) benchmark priority performance indicators and study variation across sites; (2) provide feedback to inform improvement; and (3) test the comparative effectiveness of a coach-supported QI intervention versus usual practice (control) on outcomes using a step-wedge randomized prospective design.
MS-CQI is the first multicenter quality improvement (QI) research collaborative for people with multiple sclerosis (MS) and aims to improve MS care outcomes using QI. 

MS-CQI is in Year 3 of a planned 3-year study. We collect patient reported outcomes (PROM/PREM), administrative data, and clinical electronic health record (EHR) data across four sites.  Benchmarking analyses are conducted quarterly and reported to sites.  At the beginning of Year 2, we randomized one site to QI intervention.  Two additional sites were randomized to QI at the beginning of Year 3. 

Approximately 17,000 responses for 20 PRO measures have been collected to date (n=411), including (mean, SD or range): PHQ-9 (6.1, +/- 5.0); Neuro-Qol Cognitive (48.0, +/- 9.9); PDDS (1.8 +/- 2.1); PROMIS FatigueMS (55.0, +/- 9.7); TSQM-9EFF (72.7, +/- 20.1); and WPAIIWW (19.1, +/- 22.5).  EHR data for 11 clinical measures for over 10,700 clinical encounters has been collected.  MSCQI quarterly performance is: (1) % on DMT=79.7% (75.3-82.0%); (2) brain MRI = 21.4% (16.5-25.3%); (3) ER (all cause) = 4.0% (range: 2.9-4.8%); and 4) annualized relapse rate = 7.3% (3.8-11.6%).  Significant site level variation has been observed in DMT, MRI, relapse rate, ER, depression, fatigue, anxiety, sleep, PDDS and workplace functioning.  We have also observed a threefold decrease in quarterly relapse rate in Year 2 from 12% to 3.9% (p<0.05).    
MS-CQI has demonstrated feasibility in studying system-level variation in MS-related outcomes and established effective benchmarking processes informing QI efforts.  Step-wedge randomization to QI intervention has been successful.  Findings suggest that small area variation is present across sites for important outcomes. 
Authors/Disclosures
Brant Oliver
PRESENTER 		Brant Oliver has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for @ Point of Care. The institution of Brant Oliver has received research support from Biogen.