Virtual quality improvement collaborative with primary care practices during COVID-19: a case study within a...

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Primary Care Research

Background:

• Quality Improvement Collaboratives (QICs) are recognized strategies for enhancing healthcare delivery and practice change.
• Evaluating the implementation of virtual QICs is crucial for understanding their effectiveness, especially in diverse primary care settings.
• The COVID-19 pandemic necessitated adaptations in healthcare delivery, including the shift to virtual collaborative models.

Purpose of the Study:

• To evaluate the implementation outcomes of a virtual Quality Improvement Collaborative (QIC) involving independent primary care practices.
• To assess participant engagement, quality improvement (QI) capacity, use of QI tools, and overall satisfaction with the virtual QIC model.
• To determine the feasibility and attractiveness of virtual QICs as a method for engaging independent practices in quality improvement initiatives.

Main Methods:

• A longitudinal case study design was employed to evaluate a virtual QIC over one year (July 2020-June 2021).
• Practices participated in bimonthly online meetings and monthly QI coaching sessions.
• Implementation outcomes measured included engagement (attendance, poll responses), QI capacity (coach assessments), QI tool utilization (Plan-Do-Check-Act cycles), and participant perceptions (surveys, interviews).

Main Results:

• Seven clinics from five independent primary care practices, including community health centers and rural sites, participated.
• High engagement was observed, with consistent attendance and regular QI coaching interactions.
• Significant improvements in foundational, intermediate, and advanced QI capacity were noted, alongside the initiation of 26 Plan-Do-Check-Act cycles.
• Most participants (91%) reported satisfaction with the virtual QIC experience, though challenges with real-time data and multiple electronic medical record systems were identified.

Conclusions:

• Virtual QICs can achieve high participation and satisfaction rates among independent primary care practices.
• The virtual format effectively enhanced quality improvement capacity and the utilization of QI tools over a 1-year period.
• Virtual QICs present a promising and attractive alternative for engaging independent practices in quality improvement efforts, demonstrating adaptability during public health crises.