A culture of quality

Since 1986, the physicians of Northstar have been aggressively working to improve the level of care in the communities we serve.

The road ahead

We began this path as pioneers in quality, long before it became a buzzword.

The road will never end. We view quality as a journey, not a destination. We will never use the words "good enough." We will continue to blaze new trails and pioneer new initiatives.

Quality Improvement

The word "quality" has become a buzzword in the modern media. But at Northstar, quality means more than text in huge advertisements. It is a vital part of our culture and has been since our formation in 1986.

Our Commitment in Action

There is a lot of talk about the importance of transparency and public reporting of quality measures in health care. We share these beliefs and we hold ourselves accountable to measure our performance, honestly report our performance and continually improve the quality of the care we give. We have network-wide and clinic-level programs to support our goal to be above average at the network and clinic levels of performance.

Diabetes and vascular care are two of the most reported and important areas of health care. We recently performed a mid-year review to determine our performance and to support our commitment to continuous quality improvement. We share these and future results with you to show where we are and to demonstrate our commitment to quality as you watch us improve.

Optimal Diabetes Care

This measure looks at the percentage of patients with diabetes that meet all of the following goals.

1) Maintain blood pressure less than 130/80
2) Lower LDL or "bad" cholesterol to less than 100 mg/dl
3) Control blood sugar so that A1c level is less than 8%
4) Don't smoke
5) Take an aspirin daily, for those ages 40 and older

A sample of records from each clinic was reviewed to tell us how we are doing. The table below shows the percentage of diabetes patients, ages 18-75, who met all 5 goals:

2010 Mid Year Optimal Diabetes Care
Cromwell Medical Clinic	52%
Northland Family Physicians	37%
Christopher Wenner, MD	27%
Longville Lakes Clinic	30%
Raiter Clinic	27%
Duluth Family Practice Center	20%
Central Lakes Medical Clinic	20%
Iron Range Clinic	15%
Lake Superior Internal Medicine*	7%
Network	28%

2009 Minnesota Average	19%
2009 Highest Minnesota Clinic	61%

The top two network clinics for this measure were Cromwell Medical Clinic with 52% and Northland Family Physicians with 37%. As performance leaders in our network these clinics are sharing their methods of success with the rest of the network.

*Internal Medicine practices traditionally have a higher percentage of older and sicker patients making optimal management of those patients more difficult. This is referred to as an increased “illness burden” and may lower the scores for those clinics.

Optimal Vascular Care

This measure looks at the percentage of patients with vessel disease that meet all of the following goals.

1) Maintain blood pressure less than 130/80
2) Lower LDL or "bad" cholesterol to less than 100 mg/dl
3) Don't smoke
4) Take an aspirin daily

A sample of records from each clinic was reviewed to tell us how we are doing. The table below shows the percentage of patients, ages 18-75, who met all 4 goals:

2010 Mid Year Optimal Vascular Care
Cromwell Medical Clinic	43%
Christopher Wenner, MD	27%
Northland Family Physicians	30%
Iron Range Clinic	22%
Raiter Clinic	17%
Longville Lakes Clinic	17%
Duluth Family Practice Center	17%
Central Lakes Medical Clinic	15%
Lake Superior Internal Medicine	8%
Network	21%

2009 Minnesota Average	34%
2009 Highest Minnesota Clinic	88%

The top clinic for this measure was Cromwell Medical Clinic with 43% The top performance leaders in our network are sharing their methods of success with the rest of the network.

At Northstar we

make successes, not excuses.

A RICH HERITAGE

With physician-directed, scientific evidence-based projects, Northstar has led the way in addressing urgent health care issues, often bringing them into their own clinic’s cultures before health plans or other organizations have formally addressed them. We were, if not first than among the first to tackle some of the most challenging health issues of our time.

Examples of some of the initiatives we pioneered are:

· Diabetes Management

· Tobacco Cessation

· Hypertension Management

· Recognizing and Treating Depression in Primary Care

· High Risk Pregnancy Management

· Infant Immunization

· Asthma Management

Every clinic that joins our network understands our quality mission and expressly accepted it as a major part of their organization's vision. There is no such thing as "good enough." There are always ways to improve care and we will aggressively seek to do the best and where guidelines don't exist to provide that level of care - we will develop and implement those methods best described by science, the patient's needs and sound medical judgment.

A COMMITMENT TO QUALITY FOR ALL

Northstar Physicians Network clinics have made quality care for all of their patients a priority.

· Our first and foremost concern is the health and well-being of all of our patients.

· We measure our own performance on an ongoing basis.

· We have an active and aggressive network-level plan to improve the quality of care for

all of our patients

· Our process seeks to overcome known barriers including cultural and socio-economic status.

· We are committed to treat all patients without bias or prejudice, believing the right to the highest quality care belongs to all.