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 J. Fagnan

Research output: Contribution to journalArticle

1 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Family Practice

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