Aligning Forces for Quality


[ENDED IN 2015] Each of the Aligning Forces 4 Quality (AF4Q) communities has built its initiative around a core, multi-stakeholder leadership alliance working to advance the goals and activities of AF4Q at the local level. These alliances include participation from physicians, nurses, patients, consumers and consumer groups, purchasers, hospitals, health plans, safety-net providers and others. Improving the quality of ambulatory care has been an area of focus for Aligning Forces for Quality since its inception. Ambulatory care is medical care provided on an outpatient basis—therefore, not requiring a person to be admitted to the hospital. Aligning Forces began with four pilot sites in 2006 and now includes 16 communities of various sizes and characteristics. Almost 38 million individuals live in Aligning Forces for Quality communities, stretching across 14 states and covering 253 counties. Over 35,000 primary care physicians practice in these communities, and the Robert Wood Johnson Foundation anticipates that more than half of these physicians – and many of the hundreds of hospitals – will be part of the Aligning Forces quality activities.

Seven of the sixteen AF4Q initiatives are predicated on a strong foundation of PCMH; additional information about these programs can be found on the individual program pages. For more information on the remaining 9 communities, view the Aligning Forces for Quality Alliances page. 


Payment Model: 

By working with a variety of models such as patient-centered medical homes, practice coaching, learning collaboratives and accountable care organizations, the AF4Q Alliances are developing the essential components to create an infrastructure that supports sustainable improvements in ambulatory quality. Hospital Quality Network (HQN): Communities in AF4Q are also engaging hospitals in RWJFfunded quality improvement initiatives, aimed at increasing the role of nurses in improving quality, reducing hospital readmissions among cardiac care patients, improving language services for patients who speak little English and increasing the efficiency of hospital emergency departments. Through their participation in one of four collaboratives, hospitals across the communities are increasing the quality, efficiency and equity of their care. Ambulatory Quality Network: AF4Q communities are also part of a peer-learning network that will help them build the infrastructure for ongoing improvement in primary care. The goal is to support communities in developing patient-centered medical homes and implementing and sustaining successful homegrown primary care improvement collaboratives. With expert input and facilitation, the Ambulatory Quality network will bring together local stakeholders to collaborate on improving ambulatory care in their communities, while sharing tools, strategies and lessons learned.

Other Outcomes: 

Robert Wood Johnson Foundation Findings:

Last updated August 2018
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