Development of the Tool for Advancing Practice Performance, a practice-level survey to assess primary care structures...

Area of Science:

• Health Services Research
• Primary Care Medicine
• Quality Improvement Science

Background:

• Translating evidence-based guidelines into routine primary care remains a challenge.
• Existing models for primary care practice transformation have limitations.
• Tools are needed to assess modifiable factors influencing practice performance.

Purpose of the Study:

• To develop a pragmatic tool for assessing primary care practice-level structures and processes.
• To identify factors associated with improved care quality and clinical outcomes.
• To create the Tool for Advancing Practice Performance (TAPP).

Main Methods:

• Generated 314 candidate items from literature review, Delphi study, and interviews.
• Refined items using empirical criteria and expert review.
• Developed a survey tool, revised through cognitive interviews and pilot testing with primary care providers and staff.

Main Results:

• The initial 314 items were refined to 126, then to a 113-item tool after cognitive interviews.
• Pilot testing confirmed the 113-item tool's usability.
• The final Tool for Advancing Practice Performance (TAPP) is a novel, low-burden assessment.

Conclusions:

• The TAPP enables researchers and primary care providers to identify practice-level improvement areas.
• Practices and health systems can use TAPP for self-assessment and gap identification.
• TAPP can track structures, processes, and their relationship to outcomes over time.