The Robert Bree Collaborative develops guidelines to support the core principles of appropriateness of care and evidence-based practice. The Washington State Legislature established the Bree in 2011 to provide a forum for public and private health care stakeholders to work together to improve quality, appropriateness, outcomes, and cost-effectiveness of care in Washington State. Subject matter experts and key stakeholders convene in workgroups, which produce recommendations that inform healthcare purchasing and set a standard of care for Washington State Health Care Authority. The Bree Collaborative has published reports and recommendations many important issues in healthcare including cardiovascular surgery, spine surgery, opioid use, obstetrics, oncology care, LGBTQ care and other areas where there is an opportunity for improvement.

The Washington Patient Safety Coalition (WPSC)  was conceived in 2001 in response to the Institute for Healthcare Improvement’s publication “To Err is Human.” The WPSC unites a diverse range of healthcare stakeholders to achieve common patient safety goals. A member-based program of 40+ organizations representing healthcare systems, associations, and advocacy groups across the state of Washington. Patients, employers, clinics, hospitals, insurers and others, attend its annual statewide conference.

Our Care Outcomes Assessment Programs (COAPs) are dedicated to a specific clinical specialties and are unique in that they are clinician-led and driven by successful data-driven collaboration. The COAPs have proven incredibly effective at promoting changes that result in improved quality and patient safety and reduced variability in process and outcomes. These collaboratives use chart-abstracted data from medical and surgical services to provide member hospitals with the data they need to drive continual improvement of health care that meets or exceeds established standards.  

• Cardiac Care Outcomes Assessment Program (COAP)  
• Surgical Care Outcomes Assessment Program (SCOAP) 
• Spine Care Clinical Outcomes Assessment Program (Spine COAP)   
• Obstetrical Care Outcomes Assessment Program (OB COAP)  

Provider-specific, chart-abstracted data serve as the basis for analysis and discussion within and across participating institutions. COAPs provide an opportunity to participate in regional learning collaboratives that give providers an active role in the quality improvement process. The ability to discuss and learn from others’ experiences create opportunities for actionable and sustainable improvements to reduce variation. By having access to accurate, nearly current clinical data, participants can respond to and facilitate changes that address issues with both quality and resource use components.

Smooth Transitions is a Washington state-based quality improvement program enhancing the safety of hospital transfers between home or freestanding birth centers. They bring together community midwives, hospital providers and staff, and EMS personnel to build a collaborative model of care that puts birthing families at the center. They offer presentations throughout Washington State and provide direct support to participating hospitals, and are available to consult with perinatal collaboratives and organizations in other states interested in replicating this work.

The Community Birth Data Registry was created by midwives for midwives and allows capturing and measuring perinatal care across all birth settings and provider types. Since 2018, the FHCQ has worked with midwifery leaders to build a comprehensive data repository so ALL community-based midwives in Washington state and beyond can collect their data alongside hospital data for quality improvement and research.

Communication and Resolution Program. Communication and Resolution is a process healthcare organizations can utilize to address and prevent patient harm. CRP Validation can provide health care organizations with valuable feedback regarding their CRP response to an adverse event in real-time and receive support troubleshooting challenges from a neutral panel of experts.