Abstract
BackgroundPractice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation.MethodsOne hundred thirty-six ambulatory care small to medium sized primary care practices that participated in the EvidenceNow initiative’s NC Cooperative, named Heart Health Now (HHN), fit the eligibility criteria for this analysis. We explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month intervention using a retrospective cohort design that included baseline survey data, monthly practice activity implementation data and information about facilitator’s experience. Generalized linear mixed-effects models (GLMMs) identified variables associated with greater odds of team engagement using an ordinal scale for level of team engagement.ResultsAmong our practice cohort, over half were clinician-owned and 27% were Federally Qualified Health Centers. The mean number of clinicians was 4.9 (SD 4.2) and approximately 40% of practices were in Medically Underserved Areas (MUA). GLMMs identified a best fit model. The Model presented as odd ratios and 95% confidence intervals suggests greater odds ratios of higher team engagement with greater practice QI leadership 17.31 (5.24–57.19), [0.00], and practice location in a MUA 7.25 (1.8–29.20), [0.005]. No facilitator characteristics were independently associated with greater engagement.ConclusionsOur analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services.
Highlights
Practice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings
Our analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services
At the primary care practice level, efforts to recommend appropriate aspirin use, better manage blood pressure and high cholesterol, and encourage smoking cessation are key to reducing Cardiovascular disease (CVD), a strategy referred to the “ABCS” of CVD prevention [2]
Summary
Practice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation. Primary CVD prevention is the focus of the Evidence Initiative funded by the Agency for Healthcare Research and Quality (AHRQ) where seven regional cooperatives, including Heart Health (HHN), the North Carolina cooperative, assisted small-medium-sized primary care practices in implementing quality improvement (QI) activities to enhance CVD prevention strategies. Activities included abstracting and using ABCS’s-related clinical quality measures from electronic health records (EHR) to drive change, implementing evidenced based care protocols, and enhancing general QI knowledge and skills
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
