RT Journal Article
SR Electronic
T1 Implementation and Evaluation of a Laboratory Safety Process Improvement Toolkit
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 136
OP 145
DO 10.3122/jabfm.2019.02.180109
VO 32
IS 2
A1 Bethany M. Kwan
A1 Douglas Fernald
A1 Peter Ferrarone
A1 Natalia Loskutova
A1 Jodi Summers Holtrop
A1 Elizabeth W. Staton
A1 John M. Westfall
YR 2019
UL http://www.jabfm.org/content/32/2/136.abstract
AB Purpose: The purpose of this project was to evaluate the real-world usability and usefulness of a revised version of the published Agency for Healthcare Research and Quality “Improving Your Office Testing Process” toolkit, designed to help primary care practices standardize and systematize laboratory testing processes.Method: We used a multiple case study approach to evaluate toolkit implementation in 2 primary care practices with existing quality improvement (QI) infrastructure. We collected qualitative data at baseline, midpoint (3 to 4 weeks), and follow-up (7 to 8 weeks postimplementation). Data included key informant interviews and practice site observations. Nineteen clinicians and staff participated in the interviews. Thematic analysis was used to summarize (1) how practices used the toolkit for guiding lab testing process improvement (usefulness), and (2) ease of use and practice experience with using the toolkit (usability).Results: The toolkit was perceived as easy to use and easy to follow step by step. Two components of the toolkit were particularly useful: guidance on data gathering to inform quality improvement and tools for effective practice-patient communication. The toolkit's practice and patient assessments facilitated practice-specific insights into the lab processes considered most harmful to patients and informed improvement activities.Conclusion: The usability and usefulness of the toolkit were related to the characteristics of the toolkit itself (adaptability, simplicity, and design quality and packaging, and guidance in planning) and practice processes (presence of practice champions and implementation teams). In a set of 2 practices in which laboratory testing process improvement was a high priority and where well-established QI infrastructure exists, the toolkit was easy to use with little technical assistance.