Outpatient quality improvement in academic faculty practice plans: does it exist?

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Academic Medicine

Background:

• Academic faculty practice plans (FPPs) are integral to healthcare delivery and medical education.
• The increasing emphasis on quality improvement (QI) necessitates understanding FPPs' engagement in outpatient settings.
• Existing research often focuses on inpatient QI, leaving a gap in understanding outpatient QI within FPPs.

Purpose of the Study:

• To assess the current involvement of FPPs in ambulatory care quality improvement (QI).
• To describe the structural characteristics of QI initiatives within outpatient FPPs.
• To identify facilitators and barriers impacting the development of outpatient QI programs in FPPs.

Main Methods:

• A web-based questionnaire was administered to leaders of 88 FPPs within the University HealthSystem Consortium (UHC).
• The survey collected data on organizational characteristics, QI engagement, and influencing factors.
• Descriptive statistics were used to analyze responses from 33 participating FPPs.

Main Results:

• Nearly all surveyed FPPs reported some outpatient QI activities, but only 12% met criteria for a robust QI program.
• Key indicators like dedicated outpatient quality committees and QI budgets were present in only one-third and one-fifth of FPPs, respectively.
• Patient safety and external demand drove QI efforts, while lack of human and other resources posed significant barriers.

Conclusions:

• FPPs express strong interest in outpatient QI, but their efforts are nascent and lag behind inpatient QI.
• Significant resource limitations impede the development of comprehensive outpatient QI programs and a culture of quality.
• Substantial investment in resources is required for FPPs to advance outpatient quality improvement initiatives effectively.