RT Journal Article
SR Electronic
T1 More Black Box to Explore: How Quality Improvement Collaboratives Shape Practice Change
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 149
OP 157
DO 10.3122/jabfm.2012.02.110090
VO 25
IS 2
A1 Shaw, Eric K.
A1 Chase, Sabrina M.
A1 Howard, Jenna
A1 Nutting, Paul A.
A1 Crabtree, Benjamin F.
YR 2012
UL http://www.jabfm.org/content/25/2/149.abstract
AB Background: Quality improvement collaboratives (QICs) are used extensively to promote quality improvement in health care. Evidence of their effectiveness is limited, prompting calls to “open up the black box” to better understand how and why such collaboratives work. Methods: We selected a cohort of 5 primary care practices that participated in a 6-month intervention study aimed at improving colorectal cancer screening rates. Using an immersion/crystallization technique, we analyzed qualitative data that included audio recordings and field notes of QICs and practice-based team meetings. Results: Three themes emerged from our analysis: (1) practice staff became empowered through and drew on the QICs to advance change efforts in the face of leader/physician resistance; (2) a mix of content and media in the QIC program was important for reaching all participants; (3) resources offered at the QIC did little to spur practice change efforts. Conclusion: QICs offer a potentially powerful way of disseminating health care innovations through enhanced strategies for learning and change. Creating collaborative environments in which diverse participants learn, listen, reflect, and share together can enable them to take back to their own organizations key messages and change strategies that benefit them the most.