Identifying Contextual Factors and Strategies for Practice Facilitation in Primary Care Quality Improvement Using an...

Area of Science:

• Healthcare Quality Improvement
• Primary Care Practice Transformation
• Implementation Science

Background:

• Integrating quality improvement (QI) into healthcare is increasingly emphasized.
• Practice facilitation is a key strategy for driving QI in primary care settings.
• Understanding stakeholder perspectives on QI enablers and barriers is crucial but limited.

Purpose of the Study:

• To develop a framework for assessing contextual factors, challenges, and strategies influencing practice facilitation and QI.
• To illustrate the framework's application through a real-world primary care case study.

Main Methods:

• Developed the TITO (Task, Individual, Technology, Organization) framework via participatory workshops.
• Incorporated stakeholder perspectives to identify QI and practice facilitation enablers and barriers.
• Conducted a mixed-methods case study within the Healthy Hearts in the Heartland study.

Main Results:

• The TITO framework effectively organized diverse stakeholder perspectives on QI.
• Barriers included social determinants of health, staffing, and resource limitations.
• Enablers comprised practice culture, staff engagement, effective facilitation, and resource sharing.

Conclusions:

• The TITO framework offers a generalizable structure for assessing practice facilitation and QI initiatives.
• Practice facilitators are vital for aligning stakeholders and implementing tailored strategies.
• Leveraging complementary resources can accelerate QI goal achievement in primary care.