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Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program
Megan McHugh1, Tiffany Brown2, David T Liss2,3
1Institute for Public Health and Medicine, Center for Healthcare Studies and Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois megan-mchugh@northwestern.edu.
Annals of Family Medicine
|April 11, 2018
Summary
Practice facilitation effectively supports quality improvement initiatives. However, aligning practice leader preferences with facilitator recommendations is key for optimal program intensity and success in healthcare settings.
Area of Science:
- Healthcare Quality Improvement
- Implementation Science
- Primary Care Research
Background:
- Practice facilitation is a recognized strategy for enhancing quality improvement (QI) in healthcare settings.
- Effective implementation of QI programs requires understanding the perspectives of both facilitators and practice leaders.
- The ABCS of heart health (aspirin, blood pressure, cholesterol, smoking cessation) are critical targets for primary care quality improvement.
Purpose of the Study:
- To explore and compare the perspectives of practice leaders and practice facilitators regarding a QI program.
- To identify areas of agreement and disagreement between facilitators and leaders on program implementation.
- To understand the enablers and barriers to successful QI program adoption in primary care.
Main Methods:
- Qualitative study employing semi-structured interviews with practice leaders and practice facilitators.
- Rapid qualitative analysis used for data collection, organization, and analysis.
- Study involved 17 practice leaders and 10 practice facilitators from 35 practices implementing ABCS interventions.
Main Results:
- Both groups recognized the value of provided resources, but differed on implementation pace and intensity.
- Practice leaders favored flexibility in scheduling and intervention selection, preferring targeted support like EHR guidance and smoking cessation linkages.
- Practice facilitators noted that interventions requiring minimal changes to existing care practices were perceived as easier to implement.
Conclusions:
- Dual perspectives offer a comprehensive view of implementation facilitators and barriers in QI programs.
- Targeted, simpler practice facilitation efforts may be more effective for small practices than large-scale QI projects.
- Optimizing practice facilitator-supported QI requires balancing leader preferences with implementation science principles for sustained impact.