Article Figures & Data
Figures
- Figure 1.
Participant engagement. *One practice divided into 2 working groups: a Patient Experience Survey (PES) working group and a Diabetes Performance in Practice Module (PPM) working group.
- Figure 2.
Map of interpractice collaborations around Part IV Maintenance of Certification.
Tables
Sites (n) Quality Improvement Project Part IV Module 3 Improve preventive health maintenance screening Both 1 Update patient education handouts Patient experience 1 Building knowledge of patient's personal information Patient experience 2 Increase self-management decision support Patient experience 2 Improve access Patient experience 3 Improve care coordination Patient experience 1 Educate patients on newly established ePrescribing Patient experience 1 Update laboratory follow-up procedure Patient experience 1 Improve care for patients with hypertension and at-risk patients Standard module 2 Assess diabetes care through coordination, support staff, and tracking outcomes Standard module 2 Evaluate and improve In Basket management Standard module 1 Increase the rates of retinal eye exams for patients with diabetes Standard module 2 Redesign telephone systems for prescription refills and laboratory results Patient experience - Table 2. Patient Experience Module Participant Evaluation Responses (n = 18; 85% Response Rate)
Positive Response (%) Overall opinion of Part IV activity 88.9 Quantitative questions Did this activity encourage you to work with other physicians? 88.9 How valuable did you find working with other physicians to be? 72.2 How much value did access to a Practice Coach add to your Part IV experience? 88.9 How confident are you in doing another quality improvement project? 88.9 Do you feel your competence in quality improvement has improved? 100.0 Open-ended questions Most Frequent Response (%) The content was…? Just right (100.0) What did you like most? Facilitator/practice coach (47.4) What did you like least? Extra work (16.7) - Table 3. Observations from Facilitating the Maintenance of Certification (MOC) Quality Improvement (QI) Collaborative
• Practices found that the opportunity to work on meeting the Part IV QI requirement in groups was quite helpful and enhanced their QI efforts. • QI coaching (facilitation) seems to be an essential and highly appreciated, previously missing element in the MOC Part IV process. • Individualizing response QI intervention to each practice's priorities is also essential. • Immediate engagement with practice priorities is important. • Employing a Patient Experience Survey can be particularly helpful in fostering individualization, creativity, and motivation. • Using a QI template or planning form helps individuals and practices to begin work on projects quickly and to keep on task and on track. • Learning about QI is generated and sustained most naturally and effectively as team members work on specific, personally meaningful improvement projects. • A warm welcome to systematic improvement enhances facilitation. That is, an approach that: • Helps team members to identify and utilize existing QI skills and knowledge • Encourages and helps team members to identify the assistance needed with the effort: • Regarding the kind of improvement being attempted • Regarding the technical parts of QI, such as determining outcome measures and interpreting data on a small scale • Helps team members to identify next steps • Provides gentle, consistent encouragement as teams encounter problems or obstacles • Conveys a sense of play and creativity when approaching these problems or obstacles • Helps teams mobilize and/or connect with any needed assistance, such as a particular kind of practice coaching • Provides the option of online resources as well as human sources of support and learning • Cited concerns of time and staff availability need to be taken seriously. • QI interventions can sometimes uncover interpersonal or practice dynamics that might require additional resources.
