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A practice change model for quality improvement in primary care practice.

Deborah Cohen1, Reuben R McDaniel, Benjamin F Crabtree

  • 1Department of Family Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, USA. debbiec@nac.net

Journal of Healthcare Management / American College of Healthcare Executives
|June 12, 2004
PubMed
Summary

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This summary is machine-generated.

Understanding practice change is crucial for healthcare. A new model identifies four key elements—motivation, resources, external motivators, and opportunities—that drive sustainable quality improvement in primary care practices.

Area of Science:

  • Healthcare Management
  • Quality Improvement Science
  • Primary Care Research

Background:

  • Primary care practices face constant change in a dynamic healthcare landscape.
  • Facilitating sustainable practice improvement requires a clear understanding of the change process.
  • Existing models for practice change are not well-defined.

Purpose of the Study:

  • To develop a conceptual model for understanding and facilitating practice change.
  • To identify critical variables influencing the success of quality improvement interventions.
  • To guide sustainable practice improvements in primary care.

Main Methods:

  • Comparative case-study analysis of high- and low-improvement practices from the Study To Enhance Prevention by Understanding Practice (STEP-UP) randomized clinical trial.

Related Experiment Videos

  • Evaluation of data from 79 northeastern Ohio practices focused on improving preventive service delivery.
  • Development of a conceptual model based on identified critical variables.

    • Main Results:

    • A model of practice change was developed, highlighting four key elements: stakeholder motivation, internal and external resources, external motivators, and understanding of change opportunities.
    • The model emphasizes the dynamic interrelationships between these elements.
    • Sustainable practice improvement is influenced by the complex interplay of factors both inside and outside the practice.

    Conclusions:

    • The developed model provides a framework for understanding and guiding practice change in primary care.
    • Interventions informed by this model can lead to sustainable quality improvements.
    • Addressing the four key elements and their interactions is essential for successful practice transformation.