This is 14 percent more than all hospitals with an organized quality improvement program that responded to the November 2014 American Hospital Association Survey of Care Systems and Payment. Hospitals use these programs to teach clinical leaders continuous quality improvement methods and team training, which support accountable care organization goals of better care at lower cost. Although 68 percent of ACO participants use more than one methodology, 80 percent of them have adopted Lean, which uses root cause analysis to minimize unnecessary steps. PDSA (Plan, Do, Study, Act), which tests implemented change, is used by 64 percent of ACO participants; Six Sigma, a data-driven approach to quality improvement, is used by 45 percent; and Baldrige health care criteria are used by 8 percent. Among all respondents, 61 percent use multiple methodologies; 68 percent use Lean; 66 percent use PDSA; and 9 percent use Baldrige.

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