TY - JOUR
T1 - The Importance of Practice Facilitation in Primary Care When Pandemic Takes Hold
T2 - Relationships of Resilience
AU - Hatch, Brigit A.
AU - Ferrara, Laura
AU - Dickinson, Caitlin
AU - Stock, Isabel
AU - Carney, Patricia A.
AU - Fagnan, Lyle J.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a grant from the American Cancer Society (RSG-18-022-010)
Funding Information:
When the COVID-19 pandemic hit, the ORPRN team was deeply engaged in a five-year study called “RAVE,” the R ural A dolescent V accine E nterprise funded by the American Cancer Society. RAVE provides practice facilitation to 45 primary care clinics in rural Oregon with the goal of improving Human Papilloma Virus (HPV) vaccination. At the study’s inception, the average county-level HPV series completion rate among rural Oregon counties was just 28%, far below the Healthy People 2020 goal of 80%. By March 2020 the study intervention was well underway—we had completed 10 months of longitudinal practice facilitation and developed local community partnerships with 9 clinics (the first “wedge” in our stepped-wedge research design). The study design specifies that participating clinics be randomized to one of 5 intervention wedges starting every 6 months over a 3-year period. The intervention consists of 18 months of practice facilitation aimed at: (1) developing robust systems for clinical quality improvement and (2) supporting clinics in leading a local project to improve HPV vaccination. During the intervention, clinics meet monthly with a practice facilitator and hold weekly internal meetings to conduct rapid cycle small tests of change using The Model for Improvement. Between monthly meetings, facilitators support clinics via email, telephone, and occasional drop-in visits. As a clinic-led intervention, each site chooses their own vaccination-related aim and each plan-do-study-act cycle with coaching from the practice facilitator. The study also provides funding for clinics to partner with a local community group to lead a local social marketing campaign.
Publisher Copyright:
© The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - The COVID-19 pandemic is unprecedented in recent history as radically and forcefully changing healthcare delivery. Practice facilitators, who often use tools of improvement science, have long played a critical role in supporting routine primary care practice transformation when healthcare system and policy changes occur. However, current events have taken many healthcare systems to the brink of collapse. Our practice facilitation team, which has a long history of sustained primary care partnerships in rural under-resourced settings, is finding creative solutions to carry forward work in research and quality improvement, and the tools of improvement science are well-suited to address rapidly changing demands of primary care during such a crisis. We reflect here on practice facilitation through the pandemic—the value of applied improvement science, and the critical necessity of strong relationships, flexibility, and creativity to support ongoing primary care partnerships.
AB - The COVID-19 pandemic is unprecedented in recent history as radically and forcefully changing healthcare delivery. Practice facilitators, who often use tools of improvement science, have long played a critical role in supporting routine primary care practice transformation when healthcare system and policy changes occur. However, current events have taken many healthcare systems to the brink of collapse. Our practice facilitation team, which has a long history of sustained primary care partnerships in rural under-resourced settings, is finding creative solutions to carry forward work in research and quality improvement, and the tools of improvement science are well-suited to address rapidly changing demands of primary care during such a crisis. We reflect here on practice facilitation through the pandemic—the value of applied improvement science, and the critical necessity of strong relationships, flexibility, and creativity to support ongoing primary care partnerships.
KW - COVID-19 pandemic
KW - practice facilitation
KW - practice-based research
KW - quality improvement
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U2 - 10.1177/21501327211014093
DO - 10.1177/21501327211014093
M3 - Comment/debate
C2 - 33928813
AN - SCOPUS:85105161077
SN - 2150-1319
VL - 12
JO - Journal of primary care & community health
JF - Journal of primary care & community health
ER -