How Practice Facilitation Strategies Differ by Practice Context

Nguyen, Ann M.; Cuthel, Allison; Padgett, Deborah K.; Niles, Paulomi; Rogers, Erin; Pham-Singer, Hang; Ferran, Diane; Kaplan, Sue A.; Berry, Carolyn A.; Shelley, Donna

doi:10.1007/s11606-019-05350-7

Cited by 40 publications

(56 citation statements)

References 29 publications

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“…To our knowledge, the current study is one of the first to investigate practice facilitators' perceptions and observations of implementation of a QI intervention to connect patients to community resources for heart health, the most understudied component of the Chronic Care Model. 17 This study demonstrates, as has been shown previously, 9,10,15,38 the value of the practice facilitator role for both QI process implementation and implementation research.…”

Section: Discussionsupporting

confidence: 77%

Implementation of Community-Based Resource Referrals for Cardiovascular Disease Self-Management

et al. 2020

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Section: Discussionsupporting

confidence: 77%

Implementation of Community-Based Resource Referrals for Cardiovascular Disease Self-Management

et al. 2020

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“…Responding to these requests reduced the time they could spend on the project goals but was a critically important strategy for building trust and demonstrating value to busy practices. 38 The Improved Delivery of Cardiovascular Care study likewise reported that organizational and structural aspects of primary care practices (e.g., lack of time, minimal staff engagement, and resistance to change) may have reduced the impact of the PF intervention. 15 A longer period of practice engagement often not feasible within the constraints of research trial protocols and intensity is likely needed to be able to attain improvements in guideline adherence across multiple risk factors.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Disease Guideline Adherence: An RCT Using Practice Facilitation

Shelley

Gepts

Siman

et al. 2020

American Journal of Preventive Medicine

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Introduction: Practice facilitation is a promising practice transformation strategy, but further examination of its effectiveness in improving adoption of guidelines for multiple cardiovascular disease risk factors is needed. The objective of the study is to determine whether practice facilitation is effective in increasing the proportion of patients meeting the Million Hearts ABCS outcomes: (A) aspirin when indicated, (B) blood pressure control, (C) cholesterol management, and (S) smoking screening and cessation intervention. Study design: The study used a stepped-wedge cluster RCT design with 4 intervention waves.

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“…There was demand among professionals for additional actions related to speci c core strategies within the overall implementation strategy like training actions regarding the clinical intervention. Contextual factors, for example, site characteristics, needs and priorities are considered to be among the main drivers for tailoring implementation strategies [34], and one of the approaches used is to permit exibility in order to enhance alignment and involvement while offering support and guidance towards change [33,34].…”

Section: Discussionmentioning

confidence: 99%

Fidelity Evaluation of the Compared Procedures for Conducting the PREDIAPS Implementation Strategy to Optimize Diabetes Prevention in Primary Care

Sánchez

Rogers

Pablo

et al. 2020

Preprint

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Background:Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in routine PC within the PREDIAPS randomized cluster implementation trial. Method:We conducted an observational descriptive fidelity evaluation study of the PREDIAPS implementation strategy. Nine PC centers from the Basque Health Service (Osakidetza) were allocated to two different procedures to engage physicians and nurses and deploy a implementation strategy to model and adapt the clinical intervention and its implementation to their specific contexts: a Global procedure, promoting the cooperation of all healthcare professionals from the beginning; or a Sequential procedure, centered first on nurses who then pursued the pragmatic cooperation of physicians. Process indicators of the delivery and receipt of implementation strategy actions among centers and groups compared and the comparison of documented modifications to the planned implementation strategy were used to assess the following components of fidelity: adherence, dose, quality of delivery, professionals’ responsiveness and program differentiation. Results:Generally, the procedures compared for professionals engagement and deployment of the implementation strategy were carried out with the planned differentiation. Nonetheless, some unexpected between-group differences were observed,the initial rate of collaboration of nurses being higher in the Sequential (93%) than in the Global (67%) groups. Exposure rate to the programed implementation actions (% of hours received out of those delivered) were similar in both groups by professional category, with nurses (86%) having a higher rate of exposure than physicians (75%). Professionals identified half of the planned discrete strategies and their rating of strategies’perceived usefulness was overwhelmingly positive, with few differences between Sequential and Global centers. DiscussionThe PREDIAPS implementation strategy has been implemented with high fidelity and minor unplanned reactive modifications. Professionals’ exposure to the implementation strategy was high in both groups. The centers’ organizational context (i.e., work overload) led to small mismatches between groups in participation and exposure of professionals to implementation actions.TRIAL REGISTRATIONClinicaltrials.gov identifier: NCT03254979. Registered 16 August 2017, https://www.clinicaltrials.gov/ct2/show/NCT03254979

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How Practice Facilitation Strategies Differ by Practice Context

Cited by 40 publications

References 29 publications

Implementation of Community-Based Resource Referrals for Cardiovascular Disease Self-Management

Implementation of Community-Based Resource Referrals for Cardiovascular Disease Self-Management

Cardiovascular Disease Guideline Adherence: An RCT Using Practice Facilitation

Fidelity Evaluation of the Compared Procedures for Conducting the PREDIAPS Implementation Strategy to Optimize Diabetes Prevention in Primary Care

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