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Erschienen in:

21.10.2019 | Original Researh

How Practice Facilitation Strategies Differ by Practice Context

verfasst von: Ann M. Nguyen, PhD MPH, Allison Cuthel, MPH, Deborah K. Padgett, PhD MPH MA, Paulomi Niles, CNM LM MPH, Erin Rogers, DrPH, Hang Pham-Singer, PharmD, Diane Ferran, MD MPH, Sue A. Kaplan, JD, Carolyn Berry, PhD, Donna Shelley, MD MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 3/2020

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Abstract

Background

Practice facilitation is an implementation strategy used to build practice capacity and support practice changes to improve health care outcomes. Yet, few studies have investigated how practice facilitation strategies are tailored to different primary care contexts.

Objective

To identify contextual factors that drive facilitators’ strategies to meet practice improvement goals, and how these strategies are tailored to practice context.

Design

Semi-structured, qualitative interviews analyzed using inductive (open coding) and deductive (thematic) approaches. This study was conducted as part of a larger study, HealthyHearts New York City, which evaluated the impact of practice facilitation on adoption of cardiovascular disease prevention and treatment guidelines.

Participants

15 facilitators working in two practice contexts: small independent practices (SIPs) and Federally Qualified Health Centers (FQHCs).

Main Measures

Strategies facilitators use to support and promote practice changes and contextual factors that impact this approach.

Key Results

Contextual factors were described similarly across settings and included the policy environment, patient needs, site characteristics, leadership engagement, and competing priorities. We identified four facilitation strategies used to tailor to contextual factors and support practice change: (a) remain flexible to align with practice and organizational priorities; (b) build relationships; (c) provide value through information technology expertise; and (d) build capacity and create efficiencies. Facilitators in SIPs and FQHCs described using the same strategies, often in combination, but tailored to their specific contexts.

Conclusions

Despite significant infrastructure and resource differences between SIPs and FQHCs, the contextual factors that influenced the facilitator’s change process and the strategies used to address those factors were remarkably similar. The findings emphasize that facilitators require multidisciplinary skills to support sustainable practice improvement in the context of varying complex health care delivery settings.

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Titel: How Practice Facilitation Strategies Differ by Practice Context
verfasst von: Ann M. Nguyen, PhD MPH
Allison Cuthel, MPH
Deborah K. Padgett, PhD MPH MA
Paulomi Niles, CNM LM MPH
Erin Rogers, DrPH
Hang Pham-Singer, PharmD
Diane Ferran, MD MPH
Sue A. Kaplan, JD
Carolyn Berry, PhD
Donna Shelley, MD MPH
Publikationsdatum: 21.10.2019
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 3/2020
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-019-05350-7

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How Practice Facilitation Strategies Differ by Practice Context