Successful Trial of Practice Facilitation for Plan, Do, Study, Act Quality Improvement

Area of Science:

• Health Services Research
• Primary Care Improvement
• Quality Improvement Interventions

Background:

• Practice facilitation (PF) is an emerging intervention for supporting data-driven practice change in healthcare.
• There is a need for detailed, research-based facilitation methods that balance fidelity with flexibility.
• This study addresses the need for understanding facilitation methods within a real-world trial setting.

Purpose of the Study:

• To evaluate the feasibility of practice facilitators guiding primary care practices through key driver domain activities.
• To assess the implementation and duration of Plan-Do-Study-Act (PDSA) cycles within a quality improvement framework.
• To inform the development of PF methods and protocols for future research.

Main Methods:

• Thirty-two rural primary care practices participated in a 1-year practice facilitation intervention.
• Facilitators guided practices in developing and implementing PDSAs within key driver domains.
• Data collected included the duration of PDSA activities and practice satisfaction.

Main Results:

• All participating practices completed at least 4 key driver domain activities.
• 59% of PDSAs were active for a minimum of 3 months, with variations across domains.
• 97% of practices recommended similar facilitation services, and 84% reported substantive care process changes.

Conclusions:

• Practice facilitation is a feasible method for engaging practices in quality improvement activities within a year.
• The findings support the integration of PF into future trials for refining methods and protocols.
• This research provides valuable insights for other PF research efforts aiming to improve primary care.