“ It doesn’t help when the QIO comes in, audits my charts, and tells me what a lousy job I am doing. If they would tell me who is doing a good job, maybe I could talk with them and find out how to do it better.”
For 45 years, the Cystic Fibrosis Foundation has kept track of the outcomes of every cystic fibrosis child cared for in the 117 cystic fibrosis centers around the U.S. By agreement with the centers, the data is kept confidential.
In 2003, average life expectancy of people with cystic fibrosis was 33. In the top performing center it was 47.
At the median CF center, the average FEV1 was 75% of normal. At the top center it was 100% of normal.
1889: Dept of Agriculture began issuing Farmers’ Bulletins and the Yearbook of Agriculture ; experimental farms issued research bulletins and “popular bulletins”; publications reached small proportion of farmers, many of whom distrusted “book farming”
1880 -1911: Widespread establishment of “farmers institutes” and even “mobile institutes” to reach more farmers
1906: S. A. Knapp hired the first county extension agent to develop a personal relationship with every farm family in the county and help them implement innovations
Funding sources – 30% federal, 70% state and local
Headquartered in the land-grant university
Staffing – 1% federal, 32% university, 67% local in nearly all of the 3,150 counties in the U.S.; plus more than 2 million volunteers
Goal is to maintain meaningful bi-directional communication between the university and the farmers and provide on-site training and assistance to farmers and farm families so they can stay abreast of advances in science
Taking the University to the People by Wayne D. Rasmussen; Iowa State University Press, 1989
Community Care of NC: Regional 501c3 organizations; owned and run by primary care clinicians; supported by Medicaid care management funds ($2.50 pmpm); charged with improving quality of care for Medicaid patients.
Saved the state $60 million in Medicaid costs in 2003 and $120 million in 2004