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A Randomized Trial of High-Value Change Using Practice Facilitation.

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Summary
This summary is machine-generated.

Focused practice facilitation, targeting high-value elements (HVEs), improved primary care transformation more effectively than generalized facilitation. This approach enhanced goal attainment and team collaboration for better health reform outcomes.

Keywords:
2017 PBRN IssueMedical HomePatient-Centered CarePay for PerformancePractice Faciliation

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Area of Science:

  • Health Services Research
  • Primary Care Transformation
  • Quality Improvement Science

Background:

  • Primary care transformation is vital for health reform but can cause team fatigue and inconsistent results.
  • Practice facilitation may mitigate fatigue and aid in achieving transformation goals.
  • Existing facilitation methods may benefit from a more focused approach.

Purpose of the Study:

  • To compare the impact of focused versus general practice facilitation on primary care transformation.
  • To assess effects on goal setting, action planning, and team performance.
  • To evaluate the influence on achieving high-value elements (HVEs).

Main Methods:

  • A 12-month cluster randomized trial involving 8 primary care clinics.
  • Intervention group received targeted facilitation on HVEs; control group received generalized facilitation.
  • Quantitative and qualitative methods assessed goal/action item selection and achievement, HVE attainment, and collaborative practice.

Main Results:

  • Intervention clinics focused 83% of goals on HVEs versus 27% for controls.
  • Intervention clinics met 68% of HVE goals (101 selected) compared to 61% for controls (41 selected).
  • Intervention group showed greater improvement in 4 of 8 domains of collaborative practice.

Conclusions:

  • Targeted facilitation appears more effective for achieving high-value change goals in primary care.
  • This focused approach enhances team concentration on goals, roles, and responsibilities.
  • Focused facilitation supports more successful primary care transformation efforts.