Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study

Implementation Science

Jiancheng Ye¹  Ann Wang¹  Jennifer Bannon¹  Theresa L. Walunas²  Abel N. Kho³  Justin D. Smith⁴  Nicholas Soulakis⁵ 

[1] Center for Health Information Partnerships, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 625 N. Michigan, 15th Floor, 60611, Chicago, IL, USA;Department of Medicine, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;Center for Health Information Partnerships, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 625 N. Michigan, 15th Floor, 60611, Chicago, IL, USA;Department of Medicine, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;Center for Health Information Partnerships, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 625 N. Michigan, 15th Floor, 60611, Chicago, IL, USA;Department of Preventive Medicine, Division of Healthcare and Biomedical Informatics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;Department of Population Health Science, University of Utah School of Medicine, Salt Lake City, UT, USA;Department of Preventive Medicine, Division of Healthcare and Biomedical Informatics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;

关键词: Practice facilitation;    Quality improvement;    Cardiovascular care;    Primary care;    Strategy framework;   

DOI  :  10.1186/s13012-021-01100-8

来源: Springer

【 摘 要 】

BackgroundPractice facilitation is a multicomponent implementation strategy used to improve the capacity for practices to address care quality and implementation gaps. We sought to assess whether practice facilitators use of coaching strategies aimed at improving self-sufficiency were associated with improved implementation of quality improvement (QI) interventions in the Healthy Hearts in the Heartland Study.MethodsWe mapped 27 practice facilitation activities to a framework that classifies practice facilitation strategies by the degree to which the practice develops its own process expertise (Doing Tasks, Project Management, Consulting, Teaching, and Coaching) and then used regression tree analysis to group practices by facilitation strategies experienced. Kruskal-Wallis tests were used to assess whether practice groups identified by regression tree analysis were associated with successful implementation of QI interventions and practice and study context variables.ResultsThere was no association between number of strategies performed by practice facilitators and number of QI interventions implemented. Regression tree analysis identified 4 distinct practice groups based on the number of Project Management and Coaching strategies performed. The median number of interventions increased across the groups. Practices receiving > 4 project management and > 6 coaching activities implemented a median of 17 of 35 interventions. Groups did not differ significantly by practice size, association with a healthcare network, or practice type. Statistically significant differences in practice location, number and duration of facilitator visits, and early study termination emerged among the groups, compared to the overall practice population.ConclusionsPractices that engage in more coaching-based strategies with practice facilitators are more likely to implement more QI interventions, and practice receptivity to these strategies was not dependent on basic practice demographics.

【 授权许可】

CC BY