Volume 1, July 2009 - Inside the
Inaugural Issue
Your New "Quality Connection"!
Welcome to Issue #1 of PQA's
newsletter. PQA is on the move! With so
much going on with the Pharmacy Quality Alliance and in
healthcare, in general, we want to make sure you are connected
to all the critical activities, events and other news that
matters. Enter the "PQA Quality Connection", your regular
ticket to the important inside information.
What can you expect from the
Quality Connection? Our
newsletter will land in your inbox every other month loaded
with information on key healthcare legislative developments,
reports from PQA workgroups, councils and the Executive
Director, a calendar of events and announcements on
educational opportunities around healthcare quality and
performance measurement.
Let us know what you think! We will be
refining content and fine-tuning the format of the Quality
Connection over the first few issues. We would greatly
appreciate your feedback. Send comments to QualityConnection@PQAalliance.org
PQA Adopts Broader Mission Statement and
Comprehensive Strategic Plan: Expands to Cover Medication
Use Process across All Healthcare
Settings
In
recognizing the role that medication use measures will play in
improving health outcomes and patient safety across all areas
of healthcare, the Pharmacy Quality Alliance Board of
Director's approved the adoption of a new mission statement
that repositions PQA and creates a broader focus.
Click here to read
more
PQA Appointed to the National Priorities
Partnerships
The Pharmacy Quality Alliance has been appointed to the National
Priorities Partnership Committee, an initiative convened by
the National Quality Forum (NQF).
Click here to read more
The Pharmacy Quality Alliance Elects
Three New Members to its Board of Directors:
Leaders from Humana, Pfizer and the American Pharmacists
Association Joining
Board
The Pharmacy Quality Alliance, Inc (PQA)
elected three new members to its Board of Directors' following
its quarterly Board of Directors meeting. The PQA Board
Chairman, Bruce Roberts, Executive Vice President and CEO of
the National Community Pharmacists Association, announced
the following three individuals who were unanimously approved for
a four- year term: William Fleming, PharmD, Vice President, Pharmacy
and Clinical Integration, Humana, Thomas Menighan, APhA Executive
Vice President & CEO, American Pharmacists Association (APhA) and
Eleanor M. Perfetto, PhD, MS, Senior
Director, Reimbursement & Regulatory Affairs, Federal Government Relations, Pfizer
Inc.
Click here to read more
testing
interventions that improve medication use quality and
demonstrate a high-value healthcare model to payers through
PQA demonstration projects.
Click here to read
more
The Inside Scoop: Activity reports from PQA
Workgroups, Councils and
Panels
Click here to read
more
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PQA Adopts
Broader Mission Statement and Comprehensive Strategic
Plan: Expands to Cover Medication Use
Process across All Healthcare Settings
In recognizing the role that
medication use measures will play in improving health outcomes
and patient safety across all areas of healthcare, the
Pharmacy Quality Alliance Board of Director's approved the
adoption of a new mission statement that repositions PQA and
creates a broader focus.
PQA's expanded mission
is to:
Improve the quality of
medication use across health care settings through a
collaborative process in which key stakeholders agree on a
strategy for measuring and reporting performance information
related to medications.
When PQA, was initially
established in April 2006, the PQA Steering Committee
committed to improving health care quality and patient safety
through a collaborative, consensus-based process aimed at
measuring performance at the pharmacy and
pharmacist-levels; collecting data in the least burdensome
way; and reporting meaningful information to consumers,
pharmacists, employers, payers, and other healthcare
decision-makers to help make informed choices, improve
outcomes and stimulate the development of new payment
models.
Laura Cranston, PQA's Executive Director,
recognized the five month process that a group of dedicated
PQA leaders and volunteers spent on the development of this
comprehensive plan. In releasing the plan to PQA members, she
stated, "The expanded mission statement repositions PQA and
focuses its efforts on medication use across all health care
settings. The change was driven by several key factors
including CMS' interest of having PQA focus on measures that
target evaluating the performance of health plans, primarily
involved in Medicare Part D, from a medication use
perspective. Another key consideration was the growing
interest of health plans and PBMs outside of
government-sponsored programs that are also interested in
medication use measures that have been developed through this
unique consensus based process, which includes all major
stakeholders."
To date, PQA has developed
medication use measures that have been tested by the National
Committee on Quality Assurance. Ten of the 15 measures
developed through this unique partnership focus on measures of
adherence (
proportion of days covered, and gaps in
therapy measures) in chronic disease areas such as diabetes,
asthma and cardiovascular diseases. Additionally, other
measures of patient safety and appropriate medication use have
also been approved by PQA's
membership.
Along
with the expanded mission, PQA's Board also approved a
three-year Strategic Plan that identifies three major
strategic initiatives that will support PQA's ability to
accomplish its mission.
These
initiatives are to:
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ESTABLISH PQA as "owner" of the medication use "space" and to
position PQA as the "go to" source for measure concept
development in the areas of medication utilization, MTM
services and pharmacy's health promotion and wellness
services.
-
RECOGNIZE that the model PQA
built relies on maintaining a high level of volunteerism.
This is an asset that should continue to be cultivated and
sustained. The PQA member appointees serving as volunteers
need to be engaged to a high degree. As the needs will shift
from measure concept development to measure uptake and
implementation in 2009, the PQA workgroups become a very
dynamic infrastructure with the ability to change to meet
the needs and objectives of PQA and the broader national
quality agenda.
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EDUCATE healthcare providers
involved in medication use about the quality improvement and
performance measurement initiatives and recognize the value
of pharmacists in improving health outcomes.
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PQA Appointed to the
National Priorities Partnerships
The Pharmacy Quality Alliance has been appointed to the National
Priorities Partnership Committee, an initiative convened by
the National Quality Forum (NQF).
The National
Priorities Partnership is a collaborative effort that has been
led by 28 major national organizations that collectively
influence every part of the health care system. PQA is as a
consensus-based alliance, representing a broad and growing
number of healthcare stakeholders committed to improving
medication use and medication related services across the
health care system.
Laura Cranston,
PQA's Executive Director, commented on the appointment to the
National Priorities Partnership, "As a relatively new
organization in the growing performance measurement
enterprise, we are pleased that the National Quality Forum's
(NQF) Board has expanded the members of the National
Priorities Partnership. Clearly, the NQF recognizes the
important role that pharmacists have in advancing appropriate
medication use and ensuring optimal patient outcomes through
appropriate medication management services. We look forward to
being a part of this very important collaborative
initiative."
"Pharmacists play
an important role in achieving the National Priorities and
Goals," said Janet M. Corrigan, President and CEO of the
National Quality Forum, which convened NPP in 2008. "They help ensure that
patients receive safer, better coordinated care on a daily
basis; drive the system to improve patient outcomes through
effective medication management; and are on the front lines
when it comes to truly engaging patients in and educating
patients about their care."
The Partners
address the challenges of our healthcare system and represent
multiple stakeholders drawn from the public and private
sectors. The Partners have identified a set of national
priorities and goals to help focus performance measurement
efforts on high-leverage areas -- those with the most
potential to result in substantial improvements in health and
healthcare. The 2009 PQA workgroups and quality metrics
initiatives are closely aligned with the six national
priorities identified through the National Priorities
Partnership. These six priorities for NPP
include:
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Engage patients and
families in managing their health and making decisions about
their care.
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Improve the health of the
population.
-
Improve the safety and reliability
of America's healthcare system.
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Ensure patients receive
well-coordinated care within and across all healthcare
organizations, settings, and levels of
care.
-
Guarantee appropriate and
compassionate care for patients with life-limiting
illnesses.
-
Eliminate overuse while
ensuring the delivery of appropriate
care.
For more
information click National Priority
Partnership
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The Pharmacy
Quality Alliance, Inc (PQA) elected three new members to its
Board of Directors' following its quarterly Board of Directors
meeting. The PQA Board Chairman, Bruce Roberts, Executive Vice
President and CEO of the National Community Pharmacists
Association, announced the following three individuals who
were unanimously approved for a four- year term:William Fleming, PharmD, Vice President,
Pharmacy and Clinical Integration, Humana Inc.Thomas Menighan, APhA
Executive Vice President & CEO, American Pharmacists
Association (APhA) andEleanor M. Perfetto, PhD, MS, Senior
Director, Reimbursement & Regulatory Affairs, Federal
Government Relations, Pfizer Inc
Dr.
William Fleming has been involved with PQA since its inception
and served as Co-Chair of PQA's Data Aggregation and Reporting
Workgroup during the group's initial two years. Additionally,
he serves on a number of ad hoc committees for PQA, including
its recent Strategic Planning Committee.
Dr. Eleanor
M. Perfetto has also been an integral force within
PQA. Currently, she serves as Co-Chair of the PQA
Research Coordinating Council, a post she has held since the
Council was established over two years ago. She has led efforts in
launching the five current PQA demonstration projects in Phase
I, and is assisting PQA in its research plans for broader
demonstration projects to be launched later in the
year.
Thomas Menighan is
joining PQA's activities for the first time. However, the
American Pharmacists Association (APhA) - the organization he leads
- has and continues to be a major player across several of PQA's
primary workgroups and initiatives. APhA is dedicated to
helping lead these workgroup efforts, and has appointed senior
staff liaisons to shepherd their
activities.
Laura Cranston, Executive
Director for PQA, acknowledged the service and contributions
of two of its Board members, who are rotating off the PQA
Board of Directors.
Cranston and Chairman Bruce
Roberts both recognized the service of Dr. John Gans, one of
PQA's founding members and John Fish, Vice President with
GlaxoSmithKline who has served on PQA's Board for two years,
and is retiring from his position at GlaxoSmithKline. Dr.
Gans has served on the PQA Board since PQA's establishment in
April 2006, and his leadership and guidance in these formative
years has been most valuable. Also leaving the Board is John
(Jack) Fish, Vice President of Channel Management and Pharmacy
Solutions for GlaxoSmithKline. Jack has served as the
pharmaceutical industry representative to PQA for the past two
years and has also served on PQA's Finance & Operations
Committee.
In announcing these three
new appointments, Chairman Bruce Roberts stated, "Stepping
into the role of Board Member during the discussions of
healthcare reform, gives all of us on the Board a tremendous
challenge to assist in building a high quality, affordable
healthcare system using the core building blocks of
performance measurement, quality improvement and public
reporting. In the
medication use space, the performance measurement enterprise
shows tremendous growth potential, and PQA, as a
consensus-based alliance with the broadest group of
stakeholders, is taking the appropriate steps to make
appropriate medication use an integral part of the healthcare
infrastructure."
PQA's three new
Board members, join the additional 13 existing Board members
to complete PQA's slate of Directors.
Current PQA Board
Members:
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Steven Anderson, IOM, President
& CEO, National Association of Chain Drug
Stores
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Judith Cahill, Executive
Director, Academy of Managed Care Pharmacy
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Laura Cranston, RPh, Executive
Director, PQA, Inc.
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Woody Eisenberg, MD, FACP,
Chief Medical Officer, Medco Health
Solutions
-
John Feather, PhD, CAE,
Executive Director & CEO, American Society of Consultant
Pharmacists
-
Karen Ignagni, President &
CEO, America's Health Insurance Plans
(AHIP)
-
Jeff Kelman, MD, Chief Medical
Officer, Centers for Medicare and Medicaid
Services
-
David Marshall, RPh, Vice
President, New Products, Portfolio Strategies, Teva
Pharmaceuticals USA
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Mark McClellan, MD, Director,
Engelberg Center for Health Care Reform, Brookings
Institution
-
Bruce Roberts, RPh, Executive
Vice President & CEO, National Community Pharmacists
Association
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N. Lee Rucker, Strategic Policy
Advisor, Public Policy Institute, AARP
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Bruce Sherman, MD, FCCP,
Medical Director, Global Services, The Goodyear Tire and
Rubber Company
-
Rebecca Snead, RPh, Executive
Vice President & CEO, National Alliance of State
Pharmacy Associations
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testing
interventions that improve medication use quality and
demonstrate a high-value healthcare model to payers through
PQA demonstration projects.
PQA, Inc. has received a multi-year
grant commitment from the Community Pharmacy Foundation to
supports its research proposal to test interventions that
improve medication use quality. The research will focus on use
of the PQA-endorsed measures developed in partnership with the
National Committee on Quality Assurance (NCQA).
In announcing this
grant commitment, the President of the Community Pharmacy
Foundation, Philip Burgess, RPh, shared his enthusiasm for the
work of PQA, "The PQA is uniquely positioned to drive
performance measurement and quality reporting initiatives in
the medication use arena. We have followed PQA's pioneer work
with the initial Phase I demonstration projects that involve
public and private payers, over 250 community pharmacies,
several data aggregation organizations, and health IT vendors.
We are confident that our support can help advance the work of
PQA to begin to test the effectiveness of pharmacist-based
interventions that can improve adherence, patient safety and
optimize medication management."
These medication
use measures will be used by health plans, PBMs, employers and
payers that will be participating in demonstration projects
across the country. PQA's primary objective in this research
initiative is to test and determine the effectiveness of one
or more pharmacist-based interventions aimed at improving
medication use quality by measuring changes in one or more of
PQA's initial starter set of quality measures. Phase II
demonstration projects will be selected later this year by PQA
after the evaluation of Phase I projects has been completed.
In addition to
PQA's primary objective, the Research Coordinating Council has
also recommended that demonstration projects also include the
following objectives:
-
Development of a Pharmacy-specific
Pay-for-Performance model: Test
a pay-for-performance model or other financial incentive
that reimburses the pharmacist's time to provide the
intervention(s), or develop the specifications for actuarial
modeling of a pay-for-performance model.
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Identification of the Causes of Low Performance
Scores: Determine
the main underlying causes of low initial pharmacy provider
level scores, e.g., why the patient skipped doses or took
the medication incorrectly.
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Evaluating the Impact of Pharmacist-Provided
Interventions on Health Outcomes: Further validate the pharmacy-level
measures by evaluating the impact of the interventions on
established patient-health outcomes or medical measures
(e.g., by linking to medical claims
data).
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The
Inside Scoop: Activity reports from PQA Workgroups, Councils
and Panels
MTM Cluster Group:The group is engaged in creating new Medication Therapy
Management (MTM) measures for potential adoption into pharmacy
practice. Current work is focused in on the areas of
adherence, resolution of drug related problems,
recommendations made to prescribing provider(s), and
medication changes resulting from a medication therapy
management service.
Patient Safety Cluster Group: The Patient
Safety Cluster Group held its first meeting by conference call
on June 29th. The
group reviewed the history of this committee and the measures
put forward by last year's group. The National Business
Coalition on Health (NBCH) presented to the cluster regarding
their relationship with PQA with focus a medication safety
project tied to the eValue8 tool. NABP engaged the cluster in
a discussion on their Voluntary Accreditation Program for
Community Pharmacies and CMS led a discussion of how they are
using patient safety measures in the Star Rating
Program.
Medication Reconciliation ("Med Rec") Cluster Group:
The Medication
Reconciliation Cluster Group's charge for the upcoming year is
to develop a concept paper that outlines a demonstration
project utilizing the measures developed from last year's
efforts. The
group reviewed and adopted the elements of the concept paper
and agreed upon an idea for a demonstration project utilizing
an admission trigger targeted at the health plan. The trigger
sets in motion key processes, such as a patient referral for
community-based medication reconciliation by a pharmacist upon
discharge from an acute care setting. Other necessary tools
for assuring medication continuity are also provided. The
quality of the medication reconciliation would then be
measured using the PQA Medication Reconciliation measures.
Recent work has been focused on developing the framework of
the demonstration project and transforming that information
into the needed elements of the concept
paper.
Communication
and Education (C&E) Workgroup: The C&E
Workgroup has begun its work with the development of a
communication strategy and tactics that are being implemented
by four subcommittees. Current output from this workgroup
include: the PQA Quality Connection E newsletter, our "quality
enterprise" discussion with Joachim Roski, and "EPIQ" school
of pharmacy quality curriculum training (see Calendar of
Events in this newsletter). Collectively, the subcommittees
will be producing the bi-monthly Quality Connection
E-newsletter and monthly "briefs" on PQA events, coordinating
bi-monthly "quality enterprise" conferences/webinars, and
promoting PQA and supporting educational offerings on quality
and performance measurement.
Cost of Care Cluster Group: A primary goal of this group is development of a "White
Paper on Cost of Care". Work for this project was divided up
into 16 sections with references listed for each section. A
call for volunteers to summarize the 16 sections was sent to
committee members. 3 Co-Chairs were added to the cluster including: Jessica Frank (Outcomes
Pharmaceutical Health Care)- named Co-Chair in charge
of providing articles to volunteers and methods for linking
articles to the final paper ; Pauline Chan (Dept of
California Health Services)- named Co-Chair in charge
of organizing the writing volunteers and tracking assignments,
maintaining timelines and facilitating (via PQA) co-author
work-sharing; Shelly
Winston (Mirixa)- named Co-Chair in charge of merging
summaries for the 16 sections, arranging sections into a
cohesive consistent document, and reducing redundancy, and
identifying gaps in the content.
Wellness and Prevention Cluster Group:
The PQA Wellness and Prevention Cluster Group have
conducted three meetings to date. The group was honored
to have George Isham, MD, MS, Chief Health Officer and Plan
Medical Director for Health Partners attend the first
meeting. Dr. Isham is Chair of the
National Priorities Partnership (NPP) Workgroup on Population
Health, and he shared their objectives for 2009
and beyond to assure the cluster would be aligned with the
national priorities for quality measures in the area of
prevention. The
cluster group has divided into subcommittees to facilitate
building measures in three areas of focus; immunizations,
screenings and preventive aspirin therapy. The cluster group's
objectives are to develop an outline of measures, define
numerators and denominators and determine the existence of
supporting literature for the measures, which will be then be
reported to the larger Wellness and Prevention cluster for a
vote.
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Joachim Roski to Kick Off PQA's
"Engaging the Quality
Enterprise"
Education
Sessions
The
Pharmacy Quality Alliance is pleased to invite you to a
one-hour presentation on Monday, July 27th at 1 PM
EDT.
Joachim Roski, PhD, MPH is the
Managing Director for the High-Value Health Care Project at
the Engelberg Center for Health Care
Reform at The Brookings Institution and he is also directing
and managing the efforts of the Quality Alliance Steering
Committee (QASC). Dr. Roski will be presenting
" Making Quality and
Cost Measures Widely Available: a plan for making systematic
progress over the next three
years"
During this call,
Dr. Roski will review the proposed three-year plan to
significantly advance a nationwide data collection/reporting
infrastructure and make performance measure results more
widely available. The approach being taken is guided by
public-private collaboration and builds on data sharing
already in place to support care coordination and improvement.
It does not create a separate data collection/reporting
infrastructure.
Please join us as
Dr. Roski will walk us through the draft of this three year
roadmap. Ample time will be provided for questions and
answers. The call will be limited to the first 100
participants. Please RSVP to QualityConnection@PQAalliance.org.
PQA will be
offering bi-monthly "Engaging the Quality Enterprise" discussions with
key thought leaders. The goal is to raise the level of
awareness among PQA members of key quality issues in health
care and to strengthen relationships between PQA and other
quality stakeholders. Stay tuned for information on future
sessions.
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PQA Introduces New Measure Uptake and
Implementation Strategies Workgroups
PQA is pleased to launch our last
workgroups: the
PQA Measure Uptake and Implementation Strategies Workgroup; a
series of five new subgroups.
Laura Cranston, Executive Director of
PQA, notes "this will be a most important initiative for PQA
this year....and it will likely be one of our more challenging
initiatives. It does not appear that developing measures is as
much of a challenge as having the measures implemented in a
meaningful way in the healthcare marketplace."
PQA is in the
currently in the final months of the Demonstration Projects
that were launched in last July. The experiences of the five
demo projects with the 15 initial measures will be most
helpful to the discussions that will be taking place in the
five individual subgroups in the months ahead." Cranston
adds "We will use these subgroups to focus on awareness,
implementation and uptake of these PQA measures within the
various sectors: public and private payers, federal and state
agencies, employers, health plans, and
PBMs."
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Put Your Presentation Skills to Work for
PQA
A key PQA goal is to increase
visibility and knowledge of the organization and its mission,
goals and activities. One of the ways this is accomplished is
by presentations at a wide variety of meetings across the
country using a small group of individuals that comprise the
PQA Speaker's Bureau.
This group will target key meetings
representing diverse stakeholder groups in health care
quality; pharmacy and otherwise. In addition, PQA would like
to extend its reach to smaller local and regional meetings by
recruiting members interested in a less formal
commitment.
If you are
interested in participating in the formal speakers bureau or
would just like to serve PQA in your local area, please e-mail
QualityConnection@PQAalliance.org.
Concerned you're not an expert in PQA matters? Don't let that
dissuade you. We can evaluate your knowledge and see what
level of presentation is right for you and your potential
audience. Presentation slide decks and other information are
available for your use. This is a great chance to advance
pharmacy practice by educating others on important quality
matters!
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Announcements
& Events
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Joachim Roski to Kick Off
PQA's "Engaging the Quality
Enterprise"
Education
Sessions
The Pharmacy Quality Alliance is
please to invite you to a one-hour presentation on
Monday, July 27th at 1 PM EDT.
Click here
to read
more
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PQA Introduces New Measure Uptake and
Implementation Strategies
Workgroups
PQA is pleased to launch our
last workgroups:
the PQA Measure Uptake and Implementation
Strategies Workgroups; a series of five new subgroups.
Click here to read more |
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Put Your Presentation Skills
to Work for PQA
A key PQA goal is to increase visibility
and knowledge of the organization and its mission, goals
and activities. One of the ways this is accomplished is
by presentations at a wide variety of meetings across
the country using a small group of individuals that
comprise the PQA Speaker's Bureau. Click here to read more
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PQA 2009 Calendar
of Events
July
18-22
American Association of the
Colleges of Pharmacy (AACP) Annual Meeting (Boston)
July
22: 8a-12n Special Session: The EPIQ (Educating Pharmacy
Students and Pharmacists to Improve Quality) Program: a
Train-the-Trainer Program for Pharmacy
Faculty
Developing Curriculum to Teach
Students about Pharmacy Quality and Patient Safety, Click here for meeting
information
July
27
PQA Teleconference "Making Quality and
Cost Measures Widely Available: a plan for making
systematic progress over the next three years" with
Joachim
Roski, PhD, MPH. Click here
to read more
Sept 9-11
National
Institute for Quality Improvement and Education (NIQIE)
Mastering
Continuous Performance Improvement Conference, Chicago
(Rosemont).
PQA Executive Director, Laura
Cranston and PQA member, Terry Warholak will be
presenting. Click here for
meeting
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