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

Abstract

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.

Exploring the Attributes of Exemplary Facilitators in Family Medicine Residencies: Implications for Practice Transformation

“…doi: 10.22454/FamMed.2019.774561 are limited. 2,3,6,7,11,19,20 Much research focuses on external practice facilitators who, coming into an organization from the outside, may need different skills to work with an unfamiliar group. 1,21 The goal of this project was to explore attributes of internal staff identified by family medicine residency directors as "people in the office or clinic who make things easier."…”

“…ORIGINAL ARTICLES I n health care literature, the term "practice facilitator" describes someone who assists clinicians in practice transformation projects. [1][2][3][4][5][6][7][8] These facilitators commonly work toward improving the delivery of clinical interventions, particularly preventive services [9][10] ; facilitating research and quality improvement (QI) projects [11][12] ; and implementing health information technology.…”

“…15 Not typically in formal leadership roles, they are thought to be information-givers, trainers, researchers, and advisors who possess project management and interpersonal communication skills to move ideas forward to fruition. 3,7,11 Capturing both the personal attributes and the professional competencies involved in facilitation, Harvey et al 16 in 2002 described the concept of facilitation on a continuum. The task end of the continuum is characterized by practical, taskdriven activities such as administering and supporting QI projects.…”

What Makes for Successful Registry Implementation: A Qualitative Comparative Analysis

“…We studied the experiences of practices in 1 practice transformation initiative in Colorado. The initiative provided trained external Practice Facilitators 21,22 who met with practice clinicians and staff on a regular basis to provide training in quality improvement concepts and PCMH principles to support transformation. Our study team worked with the leaders of this initiative to identify practices for this study.…”

External facilitators’ perceptions of internal facilitation skills during implementation of collaborative care for mental health teams: a qualitative analysis informed by the i-PARIHS framework

“…Therefore, there is a need for more focused qualitative work examining IF characteristics. Previous qualitative studies have examined IFs' perspectives on their role in the facilitation process, including managing projects, communicating effectively, troubleshooting problems, and supporting their team [9][10][11]. These studies employed rigorous designs involving triangulation between multiple sources of data including individual interviews and focus groups with IFs and activity logs.…”