Assessing quality improvement capacity in primary care practices

Michael L. Parchman, Melissa L. Anderson, Katie Coleman, Le Ann Michaels, Linnaea Schuttner, Cullen Conway, Clarissa Hsu, Lyle Fagnan

Research output: Contribution to journalArticle

Abstract

Background: Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation. Methods: To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Results: The QICA score was associated with prior experience managing change and moderately associated with two of the three CQMs: aspirin use (r = 0.16, p = 0.049) and blood pressure control (r = 0.18, p = 0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. Conclusions: The QICA is useful for assessing QI capacity within a practice and may serve as a guide for both facilitators and primary care practices in efforts to build this capacity and improve measures of clinical quality. Trial registration: This trial is registered with www.clinicaltrials.gov Identifier# NCT02839382, retrospectively registered on July 21, 2016.

Original languageEnglish (US)
Article number103
JournalBMC family practice
Volume20
Issue number1
DOIs
StatePublished - Jul 25 2019

Fingerprint

Quality Improvement
Primary Health Care
Aspirin
Tobacco Use Cessation
Blood Pressure
Patient-Centered Care

Keywords

  • Patient care team
  • Primary health care
  • Process assessment
  • Quality improvement

ASJC Scopus subject areas

  • Family Practice

Cite this

Parchman, M. L., Anderson, M. L., Coleman, K., Michaels, L. A., Schuttner, L., Conway, C., ... Fagnan, L. (2019). Assessing quality improvement capacity in primary care practices. BMC family practice, 20(1), [103]. https://doi.org/10.1186/s12875-019-1000-1

Assessing quality improvement capacity in primary care practices. / Parchman, Michael L.; Anderson, Melissa L.; Coleman, Katie; Michaels, Le Ann; Schuttner, Linnaea; Conway, Cullen; Hsu, Clarissa; Fagnan, Lyle.

In: BMC family practice, Vol. 20, No. 1, 103, 25.07.2019.

Research output: Contribution to journalArticle

Parchman, ML, Anderson, ML, Coleman, K, Michaels, LA, Schuttner, L, Conway, C, Hsu, C & Fagnan, L 2019, 'Assessing quality improvement capacity in primary care practices', BMC family practice, vol. 20, no. 1, 103. https://doi.org/10.1186/s12875-019-1000-1
Parchman ML, Anderson ML, Coleman K, Michaels LA, Schuttner L, Conway C et al. Assessing quality improvement capacity in primary care practices. BMC family practice. 2019 Jul 25;20(1). 103. https://doi.org/10.1186/s12875-019-1000-1
Parchman, Michael L. ; Anderson, Melissa L. ; Coleman, Katie ; Michaels, Le Ann ; Schuttner, Linnaea ; Conway, Cullen ; Hsu, Clarissa ; Fagnan, Lyle. / Assessing quality improvement capacity in primary care practices. In: BMC family practice. 2019 ; Vol. 20, No. 1.
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