Results of a Mixed-Methods Evaluation of Partnerships for Health: A Quality Improvement Initiative for Diabetes Care

Harris, Stewart B.; Paquette-Warren, Jann; Roberts, Sharon E.; Fournie, Meghan; Thind, Amardeep; Ryan, Bridget L.; Thorpe, Cathy; Terry, Amanda; Brown, Judith Belle; Stewart, Moira; Webster-Bogaert, Susan

doi:10.3122/jabfm.2013.06.120211

Cited by 19 publications

(17 citation statements)

References 36 publications

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“…The magnitude of changes (crude rate) observed in our intervention group after participation in the QIIP program is similar to that noted in an uncontrolled before-and-after evaluation of a quality-improvement initiative (Partnerships for Health) that also used the Institute for Healthcare Improvement model (9% increase in annual hemoglobin A 1c testing and 9% increase in testing for low-density lipoprotein cholesterol). 32 Our adjusted analysis, which took into account temporal changes in the control group, showed more modest increases, which highlights the importance of including a control group.…”

Section: Discussionmentioning

confidence: 99%

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

et al. 2017

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CMAJ OPEN, 5(2) E281 P rimary health care plays a key role in health care systems in Canada and around the world. 1,2 Studies consistently show that the vast majority of care is delivered in primary care settings [3][4][5][6][7] and that strong primary care systems are associated with improved outcomes and decreased health care costs. 5,8,9 In Ontario, primary care is the backbone of the publicly funded health care system, accounting for about 80% of all visits annually. 7,10 Over the past decade, improving and strengthening primary health care have been key priorities of successive governments in Ontario, which have implemented a series of reforms and initiatives in this key sector. 10 These include changes to payment models for physicians, formal enrolment of patients with primary care providers, support for multidisciplinary teams, support for the adoption of electronic health records and province-wide quality-improvement initiatives. 8,11,12 Family Health Teams represent the most highly reformed model of primary health care in Ontario and include all of the elements described above. 13 There is also consistent evidence that there is room for improvement in the quality of Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

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Section: Discussionmentioning

confidence: 99%

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

et al. 2017

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“…The United States has seen improvements in patient health outcomes and a reduction in racial and ethnic disparities following QI initiatives [147,148], with improvements in blood glucose and lipid control following implementation of the Indian Health Services Diabetes Care and Outcomes Audit [150]. Provincial and federal governments in Canada have embraced the CCM/ECCM through reform strategies to transition towards a chronic disease management approach [151,152], and QI interventions guided by them have demonstrated improvement to T2DM outcomes [153][154][155][156][157]; however Indigenous peoples, for the most part, have been excluded in Canada from these opportunities [158,159].…”

Section: Existing Strategies To Improve Chronic Disease Management Anmentioning

confidence: 99%

Call to action: A new path for improving diabetes care for Indigenous peoples, a global review

Harris

Tompkins

TeHiwi

2017

Diabetes Research and Clinical Practice

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Diabetes has reached epidemic proportions in Indigenous populations around the globe, and there is an urgent need to improve the health and health equity of Indigenous peoples with diabetes through timely and appropriate diabetes prevention and management strategies. This review describes the evolution of the diabetes epidemic in Indigenous populations and associated risk factors, highlighting gestational diabetes and intergenerational risk, lifestyle risk factors and social determinants as having particular importance and impact on Indigenous peoples. This review further describes the impact of chronic disease and diabetes on Indigenous peoples and communities, specifically diabetes-related comorbidities and complications. This review provides continued evidence that dramatic changes are necessary to reduce diabetes-related inequities in Indigenous populations, with a call to action to support programmatic primary healthcare transformation capable of empowering Indigenous peoples and communities and improving chronic disease prevention and management. Promising strategies for transforming health services and care for Indigenous peoples include quality improvement initiatives, facilitating diabetes and chronic disease registry and surveillance systems to identify care gaps, and prioritizing evaluation to build the evidence-base necessary to guide future health policy and planning locally and on a global scale.

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“…Also, multiple qualitative methods were applied to capitalize on the strengths of each method and triangulation was undertaken to merge the data rather than simply collecting data and categorically publishing separately (O’Cathain et al, 2010). This study may enhance opportunities to validate the findings from the outcomes evaluation component of Partnerships for Health by allowing inferences to be tentatively drawn between program development and program outcomes (Bamberger, Rao, & Woolcock, 2010; Harris et al, 2013). …”

Section: Discussionmentioning

confidence: 95%

“…Also, an action/change model was created to describe the hypothesized causality within the program by delineating the connections among the program’s rationale, development, implementation, and intended outcomes (Chen, 2005). The results of the outcome evaluation of “Partnerships for Health” initiative are reported elsewhere (Harris et al, 2013). …”

Section: Methodsmentioning

confidence: 99%

Improving chronic care through continuing education of interprofessional primary healthcare teams: a process evaluation

Paquette-Warren

Roberts

Fournie

et al. 2014

Journal of Interprofessional Care

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Process evaluations assess program structures and implementation processes so that outcomes can be accurately interpreted. This article reports the results of a process evaluation of Partnerships for Health, an initiative targeting interprofessional primary healthcare teams to improve chronic care in Southwestern Ontario, Canada. Program documentation, participant observation, and in-depth interviews were used to capture details about the program structure, implementation process, and experience of implementers and participants. Results suggest that the intended program was modified during implementation to better meet the needs of participants and to overcome participation barriers. Elements of program activities perceived as most effective included series of off-site learning/classroom sessions, practice-based/workplace information-technology (IT) support, and practice coaching because they provided: dedicated time to learn how to improve chronic care; team-building/networking within and across teams; hands-on IT training/guidance; and flexibility to meet individual practice needs. This process evaluation highlighted key program activities that were essential to the continuing education (CE) of interprofessional primary healthcare teams as they attempted to transform primary healthcare to improve chronic care.

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Results of a Mixed-Methods Evaluation of Partnerships for Health: A Quality Improvement Initiative for Diabetes Care

Cited by 19 publications

References 36 publications

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

Impact of a provincial quality-improvement program on primary health care in Ontario: a population-based controlled before-and-after study

Call to action: A new path for improving diabetes care for Indigenous peoples, a global review

Improving chronic care through continuing education of interprofessional primary healthcare teams: a process evaluation

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