TY - JOUR
T1 - Study protocol for "Healthy Hearts Northwest"
T2 - A 2 × 2 randomized factorial trial to build quality improvement capacity in primary care
AU - Parchman, Michael L.
AU - Fagnan, Lyle J.
AU - Dorr, David A.
AU - Evans, Peggy
AU - Cook, Andrea J.
AU - Penfold, Robert B.
AU - Hsu, Clarissa
AU - Cheadle, Allen
AU - Baldwin, Laura Mae
AU - Tuzzio, Leah
N1 - Publisher Copyright:
© 2016 The Author(s).
PY - 2016/10/13
Y1 - 2016/10/13
N2 - Background: Little attention has been paid to quality improvement (QI) capacity within smaller primary care practices which comprise nearly half of all primary care settings. Strategies for external support to build such capacity include practice facilitation (PF), shared learning opportunities, and educational outreach. Although PF has proven effectiveness, little is known about the comparative effectiveness of combining these strategies. Here, we describe the protocol of the "Healthy Hearts Northwest" (H2N) study, a randomized trial designed to address these questions while improving risk factors for cardiovascular disease. Methods/design: The targeted enrollment is 250 smaller primary care practices across Washington, Oregon, and Idaho. The study is utilizing a two-by-two factorial design to assess four different combinations of practice support: PF alone, PF with educational outreach, PF with shared learning opportunities, or PF with both. A mixed methods approach is being used for evaluation and will include data from (1) baseline and follow-up practice and staff surveys; (2) baseline and quarterly clinical performance measurement from each practice on four cardiovascular risk factors: appropriate aspirin use, blood pressure control, lipid management and smoking cessation support; and (3) a quality improvement capacity assessment (QICA) survey used by external practice facilitators to guide improvement efforts. Discussion: Results from this study will inform future large-scale practice improvement initiatives by providing comparisons of promising external practice support strategies and advance our understanding of how to build QI capacity in primary care. Trial registration: ClinicalTrials.gov,
AB - Background: Little attention has been paid to quality improvement (QI) capacity within smaller primary care practices which comprise nearly half of all primary care settings. Strategies for external support to build such capacity include practice facilitation (PF), shared learning opportunities, and educational outreach. Although PF has proven effectiveness, little is known about the comparative effectiveness of combining these strategies. Here, we describe the protocol of the "Healthy Hearts Northwest" (H2N) study, a randomized trial designed to address these questions while improving risk factors for cardiovascular disease. Methods/design: The targeted enrollment is 250 smaller primary care practices across Washington, Oregon, and Idaho. The study is utilizing a two-by-two factorial design to assess four different combinations of practice support: PF alone, PF with educational outreach, PF with shared learning opportunities, or PF with both. A mixed methods approach is being used for evaluation and will include data from (1) baseline and follow-up practice and staff surveys; (2) baseline and quarterly clinical performance measurement from each practice on four cardiovascular risk factors: appropriate aspirin use, blood pressure control, lipid management and smoking cessation support; and (3) a quality improvement capacity assessment (QICA) survey used by external practice facilitators to guide improvement efforts. Discussion: Results from this study will inform future large-scale practice improvement initiatives by providing comparisons of promising external practice support strategies and advance our understanding of how to build QI capacity in primary care. Trial registration: ClinicalTrials.gov,
KW - Cardiovascular diseases
KW - Primary health care
KW - Quality improvement
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U2 - 10.1186/s13012-016-0502-7
DO - 10.1186/s13012-016-0502-7
M3 - Article
C2 - 27737719
AN - SCOPUS:84992151885
SN - 1748-5908
VL - 11
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 138
ER -