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Related Experiment Video

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The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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Understanding quality improvement collaboratives through an implementation science lens.

Catherine Rohweder1, Mary Wangen2, Molly Black3

  • 1University of North Carolina at Chapel Hill, 200 N. Greensboro St., Suite D-15, Room 212, Carrboro, NC 27510, United States of America.

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|October 27, 2019
PubMed
Summary

Quality improvement collaboratives (QICs) enhanced colorectal cancer (CRC) screening in Federally Qualified Health Centers (FQHCs). Standardized implementation strategies improved CRC screening rates by 8.0% through increased capacity for evidence-based interventions.

Keywords:
Capacity buildingColorectal neoplasmsCommunity health centersEarly detection of cancerImplementation scienceQuality improvement

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Area of Science:

  • Healthcare Quality Improvement
  • Public Health
  • Cancer Screening

Background:

  • Quality Improvement Collaboratives (QICs) are utilized for group learning and implementing evidence-based interventions (EBIs) in healthcare.
  • Limited research systematically details implementation strategies crucial for QIC success.
  • This study addresses the gap by evaluating a QIC focused on colorectal cancer (CRC) screening in Federally Qualified Health Centers (FQHCs).

Purpose of the Study:

  • To evaluate a QIC designed to enhance CRC screening in FQHCs.
  • To align standardized implementation strategies with collaborative activities.
  • To measure implementation and effectiveness outcomes, including changes in CRC screening rates.

Main Methods:

  • A pre-test/post-test single group design with mixed methods data collection was employed.
  • Key metrics included adoption, engagement, implementation of QI tools and EBIs, and CRC screening rates.
  • A post-collaborative focus group gathered participant perceptions of implementation strategies.

Main Results:

  • Twenty-three percent of North Carolina FQHCs participated; engagement was high, though individual participation declined.
  • Participating FQHCs completed all four QIC tools (aim statements, process maps, gap/root cause analysis, PDSA cycles).
  • CRC screening rates increased by 8.0% between 2017 and 2018, indicating improved uptake of EBIs.

Conclusions:

  • The QIC positively impacted FQHC capacity to implement QI tools and EBIs for CRC screening.
  • Standardized implementation strategies were feasible and appropriate, influencing positive outcomes.
  • The study supports the effectiveness of QICs in improving cancer screening rates within FQHC settings.