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Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study
- Source :
- BMC Health Services Research, Vol 20, Iss 1, Pp 1-11 (2020), BMC Health Services Research
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background Practice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation. Methods One hundred thirty-six ambulatory care small to medium sized primary care practices that participated in the EvidenceNow initiative’s NC Cooperative, named Heart Health Now (HHN), fit the eligibility criteria for this analysis. We explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month intervention using a retrospective cohort design that included baseline survey data, monthly practice activity implementation data and information about facilitator’s experience. Generalized linear mixed-effects models (GLMMs) identified variables associated with greater odds of team engagement using an ordinal scale for level of team engagement. Results Among our practice cohort, over half were clinician-owned and 27% were Federally Qualified Health Centers. The mean number of clinicians was 4.9 (SD 4.2) and approximately 40% of practices were in Medically Underserved Areas (MUA). GLMMs identified a best fit model. The Model presented as odd ratios and 95% confidence intervals suggests greater odds ratios of higher team engagement with greater practice QI leadership 17.31 (5.24–57.19), [0.00], and practice location in a MUA 7.25 (1.8–29.20), [0.005]. No facilitator characteristics were independently associated with greater engagement. Conclusions Our analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services.
- Subjects :
- medicine.medical_specialty
Quality management
Health informatics
Health administration
03 medical and health sciences
0302 clinical medicine
Ambulatory care
Nursing
medicine
Humans
030212 general & internal medicine
Retrospective Studies
Patient Care Team
Primary Health Care
business.industry
lcsh:Public aspects of medicine
030503 health policy & services
Health Policy
Public health
Nursing research
lcsh:RA1-1270
Quality Improvement
Cardiovascular Diseases
Facilitator
Facilitation
0305 other medical science
business
Research Article
Subjects
Details
- ISSN :
- 14726963
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....427bed5ed069eef9de2f36251fe4e021