An Overview of Practice Facilitation Programs in Canada: Current Perspectives and Future Directions

Liddy, Clare; Laferriere, Dianne; Baskerville, Bruce; Dahrouge, Simone; Knox, Lyndee; Hogg, William

doi:10.12927/hcpol.2013.23177

Cited by 28 publications

(36 citation statements)

References 14 publications

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“…Such "facilitation networks" have been promoted by organizations such as the Agency for Healthcare Research and Quality to promote practice facilitation networks for improving the uptake and adoption of new knowledge in the form of evidence into primary care practice (Knox et al, 2011). It is within the role and remit of expert facilitators to establish such networks both to promote the uptake of evidence into practice (Baskerville et al, 2012;Liddy et al, 2013) and using facilitation methods to promote longerterm sustainably (Hogg, Lemelin, Moroz, Sots, & Russell, 2008).…”

Section: Facilitation Rolesmentioning

confidence: 99%

Methods to Succeed in Effective Knowledge Translation in Clinical Practice

Kitson

Harvey

2016

J of Nursing Scholarship

122

113

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Section: Facilitation Rolesmentioning

confidence: 99%

Methods to Succeed in Effective Knowledge Translation in Clinical Practice

Kitson

Harvey

2016

J of Nursing Scholarship

122

113

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“…In Canada one of the first documented primary healthcare facilitation studies was conducted in 1997 in Ontario by Lemelin et al, who reported substantial improvement in the delivery of preventive services in the study arm supported by a practice facilitator [ 15 ]. However, only recently has the practice facilitator role been used in QI initiative programs in Canada [ 6 , 16 ], and it is still used infrequently [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Practice facilitators, also known as practice coaches or QI coaches, work closely with practices to identify areas of improvement, set improvement goals, provide tools, and facilitate QI activities and practice redesign in primary healthcare settings [ 17 ]. They are described as healthcare professionals who assist practice staff to assess care processes, plan implementation measures and improve strategies for illness prevention [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The role of the practice facilitators in Ontario primary healthcare quality improvement

et al. 2015

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BackgroundPractice facilitation is a key component of quality improvement in primary healthcare. Studies have reported the effectiveness of practice facilitation in improving quality management and care delivery. However, little has been published about practice facilitators’ training, facilitation activities, and their perceived role in quality improvement in primary healthcare. This study examined practice facilitators’ training and the perceptions of the practice facilitator role in a provincial primary healthcare learning collaborative quality improvement initiative in Ontario, Canada.MethodDescriptive and qualitative methods were used to outline the practice facilitator training as well as to look into the experiences and perceptions of practice facilitators and primary healthcare teams regarding the practice facilitation role in quality improvement. Data collection included training artifacts, activity logs, self-reflection reports, and semi-structured interviews with practice facilitators and primary healthcare participants. Reflections and interviews were analyzed to identify the role of the practice facilitators from their own experience, and from the perspective of the participants. Descriptive statistics were used to learn about categories of facilitation activities undertaken and frequency of these activities.ResultsSixteen practice facilitators and seven family healthcare teams participated in the study. Practice facilitators received a two-day intensive training workshop and continued training. Their time was spent mostly working directly with participating teams, continued learning and training, communications and administration. They served as coaches, resource providers, enablers and motivators. Participating teams expressed satisfaction with the practice facilitator role, although they had hoped this position would provide onsite and hands-on support in conducting activities of quality improvement at the practice level.ConclusionsPractice facilitators played a crucial role in the implementation of quality improvement in Ontario’s learning collaborative program. The practice facilitator role is perceived to be that of a coach, enabler and motivator. This study suggests that the practice facilitator successfully supported participating teams to undertake quality improvement activities in primary healthcare settings.

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“…We believe this is an important area for future development to build capacity for improvement within primary care and enhance sustainability over the longer term. Practice-based facilitation is an area of growing interest and activity [ 21 , 22 ] and one that clearly involves a substantive investment in terms of people, time and resources. There are many questions still to be answered to better understand the appropriate balance between investment costs and benefits realization, for example: who should take on the facilitator role?…”

Section: Lessons Learnedmentioning

confidence: 99%

Improving the identification and management of chronic kidney disease in primary care: lessons from a staged improvement collaborative

Harvey

Oliver

Humphreys

et al. 2014

International Journal for Quality in Health Care

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Quality problemUndiagnosed chronic kidney disease (CKD) contributes to a high cost and care burden in secondary care. Uptake of evidence-based guidelines in primary care is inconsistent, resulting in variation in the detection and management of CKD.Initial assessmentRoutinely collected general practice data in one UK region suggested a CKD prevalence of 4.1%, compared with an estimated national prevalence of 8.5%. Of patients on CKD registers, ∼30% were estimated to have suboptimal management according to Public Health Observatory analyses.Choice of solutionAn evidence-based framework for implementation was developed. This informed the design of an improvement collaborative to work with a sample of 30 general practices.ImplementationA two-phase collaborative was implemented between September 2009 and March 2012. Key elements of the intervention included learning events, improvement targets, Plan-Do-Study-Act cycles, benchmarking of audit data, facilitator support and staff time reimbursement.EvaluationOutcomes were evaluated against two indicators: number of patients with CKD on practice registers; percentage of patients achieving evidence-based blood pressure (BP) targets, as a marker for CKD care. In Phase 1, recorded prevalence of CKD in collaborative practices increased ∼2-fold more than that in comparator local practices; in Phase 2, this increased to 4-fold, indicating improved case identification. Management of BP according to guideline recommendations also improved.Lessons learnedAn improvement collaborative with tailored facilitation support appears to promote the uptake of evidence-based guidance on the identification and management of CKD in primary care. A controlled evaluation study is needed to rigorously evaluate the impact of this promising improvement intervention.

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An Overview of Practice Facilitation Programs in Canada: Current Perspectives and Future Directions

Cited by 28 publications

References 14 publications

Methods to Succeed in Effective Knowledge Translation in Clinical Practice

Methods to Succeed in Effective Knowledge Translation in Clinical Practice

The role of the practice facilitators in Ontario primary healthcare quality improvement

Improving the identification and management of chronic kidney disease in primary care: lessons from a staged improvement collaborative

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