Achievable Benchmarks of Care for Primary Care Quality Indicators in a Practice-Based Research Network

Wessell, Andrea M.; Liszka, Heather A.; Nietert, Paul J.; Jenkins, Ruth G.; Nemeth, Lynne S.; Ornstein, Steven M.

doi:10.1177/1062860607310774

Cited by 15 publications

(16 citation statements)

References 25 publications

(23 reference statements)

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Section: Methodsmentioning

confidence: 99%

“…Wessell et al [122] identify Achievable Benchmarks of Care (ABCs) for 54 quality indicators based on data collected through the Practice Partner Research Network (PPRNet) demonstration. Twenty-five to 99% of the PCPs participating in the PPRNet demonstration met the ABCs [122]. A New Zealand effort identified 28 evidence-based, population-focused indicators that may be used to assess quality of primary care in five categories: smoking cessation, prescribing practices, chronic disease management, preventive health, and quality of data [123].…”

Section: Methodsmentioning

confidence: 99%

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The Impact of Primary Care: A Focused Review

2012

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Primary care serves as the cornerstone in a strong healthcare system. However, it has long been overlooked in the United States (USA), and an imbalance between specialty and primary care exists. The objective of this focused review paper is to identify research evidence on the value of primary care both in the USA and internationally, focusing on the importance of effective primary care services in delivering quality healthcare, improving health outcomes, and reducing disparities. Literature searches were performed in PubMed as well as “snowballing” based on the bibliographies of the retrieved articles. The areas reviewed included primary care definitions, primary care measurement, primary care practice, primary care and health, primary care and quality, primary care and cost, primary care and equity, primary care and health centers, and primary care and healthcare reform. In both developed and developing countries, primary care has been demonstrated to be associated with enhanced access to healthcare services, better health outcomes, and a decrease in hospitalization and use of emergency department visits. Primary care can also help counteract the negative impact of poor economic conditions on health.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Impact of Primary Care: A Focused Review

2012

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“…[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Accordingly, we leveraged a large sample of small to medium-size primary care practices in the United States to (1) assess the extent to which they use QI strategies as measured by the Change Process Capability Questionnaire (CPCQ) Strategies Scale, and (2) evaluate practice characteristics and contextual factors that may explain variations in use of QI strategies.…”

Section: Introductionmentioning

confidence: 99%

Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices

et al. 2018

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PURPOSE Improving primary care quality is a national priority, but little is known about the extent to which small to medium-size practices use quality improvement (QI) strategies to improve care. We examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US states to improve quality of care for heart health and assessed factors associated with those variations. METHODSIn this cross-sectional study, practice characteristics were assessed by surveying practice leaders. Practice use of QI strategies was measured by the validated Change Process Capability Questionnaire (CPCQ) Strategies Scale (scores range from -28 to 28, with higher scores indicating more use of QI strategies). Multivariable linear regression was used to examine the association between practice characteristics and the CPCQ strategies score. RESULTSThe mean CPCQ strategies score was 9.1 (SD = 12.2). Practices that participated in accountable care organizations and those that had someone in the practice to configure clinical quality reports from electronic health records (EHRs), had produced quality reports, or had discussed clinical quality data during meetings had higher CPCQ strategies scores. Health system-owned practices and those experiencing major disruptive changes, such as implementing a new EHR system or clinician turnover, had lower CPCQ strategies scores.CONCLUSION There is substantial variation in the use of QI strategies among small to medium-size primary care practices across 12 US states. Findings suggest that practices may need external support to strengthen their ability to do QI and to be prepared for new payment and delivery models. INTRODUCTIONH ealth care delivery is evolving in the United States, with increasing emphasis on insurance payments based on improving quality instead of merely delivering health care services. 1 This emphasis has brought a greater focus on population health management, quality measurement, and health care outcomes. Primary care practices use quality improvement (QI) strategies, such as monitoring and assessing outcomes, having skilled QI teams, and using system redesigns to improve patient and population health outcomes, system performance, and clinician experience, and to reduce health care costs.2-6 Implementing QI strategies can help practices deliver appropriate health services efficiently and improve health outcomes, [7][8][9][10] yet much of what we know about the use of QI strategies in medical care comes from surveys conducted mostly in hospitals and health systems. [11][12][13][14][15][16][17] Little is known about the use of QI strategies in small to medium-size primary care practices, where more than one-half of Americans receive care for their chronic conditions. 18 Earlier studies have lacked generalizability because of small sample sizes and limited contextual diversity. Better understanding of the prevalence and reasons for variation in use of QI strategies among smaller practices is needed...

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“…(C. I. Kiefe, et al, 1998a; Weissman, et al, 1999; Wessell, et al, 2008) For each practice, the proportion of patient up-to-date by each screening modality was calculated.…”

Section: Study Design and Methodsmentioning

confidence: 99%

Colorectal Cancer Screening in Primary Care: Theoretical Model to Improve Prevalence in the Practice Partner Research Network

Nemeth

Jenkins

Nietert

et al. 2009

Health Promotion Practice

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Colorectal cancer (CRC) is the second leading cause of cancer death in the United States (US). Half of Americans above age 50 are not current with recommended screening; research is needed to assess the impact of interventions designed to increase receipt of CRC screening. The Colorectal Cancer Screening in Primary Care (C-TRIP) study is a theoretically-informed group randomized trial within 32 primary care practices. Baseline median proportion of active patients aged 50 years or older up-to-date with CRC screening among the 32 practices was 50.8% (N=55,746). Men were more likely to be screened than women (52.9% vs. 49.2% respectively). Patients 50–59 years of age were less likely to be up-to-date with screening (45.4%) than those in the 60–69 year and 70–79 years groups (58.5% in both groups). Opportunities exist to increase the proportion of CRC screening received in adults age 50 and older. C-TRIP evaluates the effectiveness of a model for improvement for increasing this proportion.

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Achievable Benchmarks of Care for Primary Care Quality Indicators in a Practice-Based Research Network

Cited by 15 publications

References 25 publications

The Impact of Primary Care: A Focused Review

The Impact of Primary Care: A Focused Review

Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices

Colorectal Cancer Screening in Primary Care: Theoretical Model to Improve Prevalence in the Practice Partner Research Network

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