Little attention has been paid to quality improvement (QI) capacity within smaller primary care practices which comprise nearly half of all primary care settings. Strategies for external support to build such capacity include practice facilitation (PF), shared learning opportunities, and educational outreach. Although PF has proven effectiveness, little is known about the comparative effectiveness of combining these strategies. The authors describe the protocol of the Healthy Hearts Northwest study, a randomized trial designed to address these questions while improving risk factors for cardiovascular disease.
The study's primary aim is to compare the effectiveness of adding shared learning opportunities, educational outreach, or both to PF for building QI capacity within smaller primary care practices, with a focus on cardiovascular disease risk-factor control. A secondary aim is to assess if PF alone improves clinic-level ABCS outcomes ("Aspirin-Blood pressure-Cholesterol-Smoking cessation"). Practice facilitation is given to all practices in our randomized trial population.
Citation: Study protocol for “Healthy Hearts Northwest”: a 2X2 randomized factorial trial to build quality improvement capacity in primary care. Michael L. Parchman, Lyle J. Fagnan, David A. Dorr, Peggy Evans, Andrea J. Cook, Robert B. Penfold, Clarissa Hsu, Allen Cheadle, Laura-Mae Baldwin and Leah Tuzzio. Implementation Science. 201611:138. DOI: 10.1186/s13012-016-0502-7.