Table 3 Build QI capacity and improve outcomes. ERIC strategies included in EvidenceNOW interventions with Proctor specifications
Expected outcomes: Improve ABCS outcomes and QI capacity Improved ABCS measures and increased practice capacity to take on new quality initiatives. Additional outcomes may vary by cooperative (e.g., joy in practice). Knowledge of evidence-based guidelines and QI techniques and principles is needed Justification: practices are under-resourced for quality improvement and need external support to guide them through the change process. Implementation staff needs a supportive infrastructure to help them help practices achieve their goals | |||||
|---|---|---|---|---|---|
No. co-ops | Name it | Specify it | |||
ERIC cluster | ERIC strategy* | Actor | Specific action(s) | Target | |
7 | Provide interactive assistance | Implementation facilitation | PF | Assist with the change process and support change efforts; review workflows and create actionable plans to put best practices in place (i.e., huddles, pre-visit planning, medication synchronization, gaps analysis, outreach, decision support use, patient education, etc.) | Practice |
7 | Use evaluative and iterative strategies | Assess for readiness and identify barriers and facilitators | Data expert HIT-PF, PF | Assess HIT needs and data set-up and workflow; assess clinic workflows; assess use of evidence-based protocols | Practice |
7 | Use evaluative and iterative strategies | Develop an implementation blueprint | PF, HIT-PF | Discuss and identify improvement plan; adjust plans according to data; develop actionable plans for implementation of evidence-based protocols and addressing other pain points (i.e. non-compliant patients) | Practice |
6 | Use evaluative and iterative strategies | Conduct cyclical small tests of change | PF | Develop and use Plan Do Study Act (PDSA), Define Measure Analyze Improve and Control (DMIAC), and other tests of change activities and processes involved in QI | Practice |
5 | New | Assess and redesign workflow | PF | Assess and revise clinic workflows using a variety of techniques (i.e., observations and mapping of workflow, role-redesign exercises) to facilitate discussion and implementation of evidence-based protocols | Practice |
4 | Support clinicians | Remind clinicians | PF | Assist the change process through use of clinical reminders and decision-support tools | Practice |
4 | Develop stakeholder interrelationships | Identify and prepare champions | PF | Assist in creating and engaging practice leaders and others in promoting efficient care strategies | Practice |
4 | Develop stakeholder interrelationships | Recruit, designate and train for leadership | PF | Assist in creating and facilitating practice leaders and others in promoting efficient care strategies | Practice |
4 | Develop stakeholder interrelationships | Organize implementation teams and team meetings | PF | Assist in creating and facilitating QI teams in promoting efficient care strategies | Practice |
4 | Engage consumers | Intervene with patients/consumers to enhance uptake and adherence | PF | Help generate patient lists for outreach from EHRs or registries; recall patients; offer patient education materials | Practice |
5 | Develop stakeholder interrelations | Use an implementation advisor | Expert consultant PF-HIT | Support and education for practice facilitators by data experts and/or physician faculty hired as expert consultants | PF |