How Complexity Science Can Inform a Reflective Process for Improvement in Primary Care Practices

The effects of teamwork and system support on colorectal cancer screening in primary care practices

“…The ULTRA study used a multi-method assessment process [18] to inform a facilitated team-building intervention [19] aimed at improving guideline adherence for multiple chronic diseases among 60 practices in New Jersey and Pennsylvania. For this analysis, 22 suburban practices were selected that had medical records with at least 10 years of data, thus allowing the calculation of rates of colonoscopy screening as a primary outcome measure.…”

Colorectal cancer screening among obese versus non-obese patients in primary care practices

“…ULTRA's primary aim was to evaluate the effectiveness of a facilitated team-building intervention in improving adherence to guidelines for multiple chronic diseases. [17] Baseline chart audit data from this intervention study was used for this analysis.…”

Practice Context Affects Efforts to Improve Diabetes Care for Primary Care Patients: A Pragmatic Cluster Randomized Trial

“…Practices in the RAP arm received practice facilitation using the Reflective Adaptive Process change model based on complexity theory. 9,[24][25][26] The RAP approach focused on changing organizational functioning in order to improve diabetes care. The conceptual model underlying this approach assumes that improving organizational capacity to make and sustain change is fundamental in achieving practice improvements and implementing changes.…”