Practice facilitators’ and leaders’ perspectives on a facilitated quality improvement program

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2 Citations (Scopus)

Abstract

PURPOSE Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators’ and practice leaders’ perspectives on implementation of a practice facilitator– supported quality improvement program and describe where their perspectives aligned and diverged. METHODS We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. RESULTS We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program’s ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. CONCLUSIONS The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator–supported efforts rather than larger, comprehensive quality improvement projects.

Original languageEnglish (US)
Pages (from-to)S65-S71
JournalAnnals of Family Medicine
Volume16
DOIs
StatePublished - Apr 1 2018

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Quality Improvement
Smoking Cessation
Aptitude
Electronic Health Records
Documentation
Aspirin
Appointments and Schedules
Cholesterol
Interviews
Blood Pressure
Health

Keywords

  • Practice facilitation
  • Qualitative research
  • Quality improvement

ASJC Scopus subject areas

  • Family Practice

Cite this

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title = "Practice facilitators’ and leaders’ perspectives on a facilitated quality improvement program",
abstract = "PURPOSE Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators’ and practice leaders’ perspectives on implementation of a practice facilitator– supported quality improvement program and describe where their perspectives aligned and diverged. METHODS We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. RESULTS We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program’s ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. CONCLUSIONS The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator–supported efforts rather than larger, comprehensive quality improvement projects.",
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N2 - PURPOSE Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators’ and practice leaders’ perspectives on implementation of a practice facilitator– supported quality improvement program and describe where their perspectives aligned and diverged. METHODS We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. RESULTS We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program’s ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. CONCLUSIONS The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator–supported efforts rather than larger, comprehensive quality improvement projects.

AB - PURPOSE Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators’ and practice leaders’ perspectives on implementation of a practice facilitator– supported quality improvement program and describe where their perspectives aligned and diverged. METHODS We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. RESULTS We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program’s ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. CONCLUSIONS The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator–supported efforts rather than larger, comprehensive quality improvement projects.

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