The collaborative method: an effective performance improvement tool for reducing inappropriate admissions.

TMF Health Quality Institute (TMF) is the Medicare quality improvement organization for Texas. Under its contract with the Centers for Medicare and Medicaid Services, an agency of the U.S. Department of Health and Human Services, TMF undertook an initiative to reduce unnecessary Medicare 1-day hospital admissions in Texas. The initiative used the Institute for Healthcare Improvement's collaborative model design for improvement. Hospitals in the collaborative focused on the admission process in combination with education of physicians, utilization managers, and case managers, resulting in a 19% decrease in 1-day stays among participant hospitals and demonstrating that the collaborative model can be used successfully to improve utilization management.