Findings and lessons learnt implementing a cardiovascular disease quality improvement program in Australian primary...

Area of Science:

• General Practice
• Cardiovascular Disease (CVD)
• Quality Improvement (QI)

Background:

• Discrepancies exist between evidence-based guidelines for cardiovascular disease (CVD) screening/management and Australian general practice implementation.
• Quality Improvement (QI) initiatives are designed to bridge these gaps.
• This study evaluated the QPulse QI program focused on CVD assessment and management.

Purpose of the Study:

• To evaluate the effectiveness of the QPulse QI program in improving CVD screening and management in Australian general practices.
• To explore barriers and enablers to the implementation of the QI program.

Main Methods:

• A mixed-methods study involving 34 general practices.
• Pre- and post-intervention measurements of CVD screening and management.
• Qualitative analysis of Plan-Do-Study-Act (PDSA) goals and thematic analysis of interviews using Normalisation Process Theory (NPT).

Main Results:

• No significant changes were observed in the documentation of risk factors, attainment of blood pressure/lipid targets, or prescription of CVD risk-reducing medications post-intervention.
• Some practices showed isolated improvements in recording waist circumference, BMI, and smoking assessment.
• Identified challenges included lack of time, need for technical support, perceived lack of value, knowledge dissemination issues, team tensions, and a part-time workforce.

Conclusions:

• Significant barriers were identified in Australian general practices, hindering the effective operationalization of the QI program.
• Factors such as lack of internal capacity, leadership, competing demands, and insufficient external support contributed to the program's limited success.