RT Journal Article
SR Electronic
T1 Successful Trial of Practice Facilitation for Plan, Do, Study, Act Quality Improvement
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 991
OP 1002
DO 10.3122/jabfm.2021.05.210140
VO 34
IS 5
A1 Kent F. Sutton
A1 Erica L. Richman
A1 Jennifer R. Rees
A1 Liza L. Pugh-Nicholson
A1 Macie M. Craft
A1 Shannon H. Peaden
A1 Monique Mackey
A1 Jacqueline R. Halladay
A1 Southeastern Collaboration to Improve Blood Pressure Writing Group
YR 2021
UL http://www.jabfm.org/content/34/5/991.abstract
AB Background: Practice facilitation (PF) is a promising but relatively new intervention supporting data-driven practice change. There is a need to better detail research-based facilitation methods, which must balance intervention fidelity and time restrictions with the flexibility required for the intervention. As part of a multi-level 4-armed cluster randomized clinical trial (RCT), 32 rural primary care practices received PF for 1 year. We evaluated the feasibility of having facilitators guide practices to perform 4 key driver domain activities, implemented as Plan-Do-Study-Act (PDSA) cycles, to better understand facilitation “exposure.” We describe the intervention and activity length such that our experiences may be useful to other PF research efforts.Methods: Thirty-two practices serving rural patients involved in the Southeastern Collaboration to Improvement Blood Pressure Control engaged with a facilitator to develop and implement PDSAs nested within key drivers of change domains. Numbers of months practices worked on activities deemed most likely to be sustained were captured along with practice satisfaction data.Results: All practices engaged in at least 4 domain-level activities, and 59% of the PDSAs were active for at least 3 months. There was variation by domain in the average length of the PDSA activities. Ninety-seven percent (31 of 32) of practices recommended similarly structured facilitation services to other primary care practices, and 84% (27 of 32) noted substantive changes in their care processes.Conclusion: In this trial, it was feasible for PFs to engage practices in at least 4 Key Driver quality improvement activities within 1 year, which will inform PF methods and protocol development in future trials.