Practice facilitators: a review of the literature

Practice facilitators (PFs) are health care professionals who assist primary care clinicians in research and quality improvement projects. Although they have been used in Europe and Australia for more than 20 years, the concept is relatively new in the United States. The recent evolution of primary care practice-based research networks (PBRNs) has led to greater awareness and expansion of this concept.

This study's objective was to review the literature on PFs and describe their origin, training, funding, roles, methods they use, and their impact on patient care outcomes in primary care.

We searched four electronic databases from 1966 through the present, reviewing all articles pertaining to PFs in an effort to understand the history, training, financing, roles, methods, and impact of PFs.

Since the early 1980s, PFs have worked with individual practices on relationship building, education, and quality improvement (QI), particularly in the area of prevention. A number of publications provide information on the roles of PFs in primary care and methods they use to enhance practices. Many prospective, uncontrolled studies and a few randomized, controlled trials have documented the effectiveness of PFs but usually in combination with other interventions. A number of primary care PBRNs in the United States have begun to use PFs as a way to bridge the gap between research and practice. Limited information has been published about the training and funding of PFs.

The PF concept seems to be a useful practice enhancement approach in primary care.