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  1. IMPROVE : Bridge Over Troubled Waters.

    Article - En anglais


    The original collaborative project was described in a 1955 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 : HealthPartners 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.

    Status : 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.

    Summary : The IMPROVE collaboration survived and flourished in a very competitive market. (...)

    Mots-clés Pascal : Amélioration, Processus, Méthodologie, Protection sociale, Soin, Prévention, Santé, Politique sanitaire, Système santé, Qualité

    Mots-clés Pascal anglais : Improvement, Process, Methodology, Welfare aids, Care, Prevention, Health, Health policy, Health system, Quality

    Logo du centre Notice produite par :
    Observatoire Régional de la Santé Auvergne-Rhône-Alpes

    Code Inist : 002B30A11. Création : 19/02/1999.