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Sustainability of a practice-individualized preventive service delivery intervention
Kurt C Stange1, Meredith A Goodwin, Stephen J Zyzanski
1Department of Family Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA. kcs@po.cwru.edu
Background:
The long-term effect of most interventions has not been studied. Changes due to interventions to improve patient care may revert to baseline after the intervention stimulus ends. This analysis reports the 24-month follow-up of a practice-tailored intervention to increase preventive service delivery rates.
Design:
Group randomized clinical trial with 24-month follow-up of intervention sites.
Setting/Participants:
Seventy-seven community family practices in northeast Ohio.
Intervention:
Practice-individualized facilitation of implementation of tools and approaches.
Main Outcome Measures:
Summary scores of health habit counseling, screening, and immunization services recommended by the U.S. Preventive Services Task Force that were up to date for consecutive patients during randomly selected chart review days.
Results:
Previously reported increases in global preventive service delivery rates, health habit counseling, and screening rates at 12 months were sustained after 24 months.
Conclusions:
A practice-individualized approach can result in sustainable increases in rates of preventive service delivery, even 1 year after the outside intervention stimulus ends. Tailoring of approaches to the unique characteristics of each practice may result in institutionalization of changes.