A practice change model for quality improvement in primary care practice

Title

A practice change model for quality improvement in primary care practice

Creator

Cohen D; McDaniel R R; Crabtree B F; Ruhe M C; Weyer S M; Tallia A; Miller W L; Goodwin M A; Nutting P; Solberg L I; Zyzanski S J; Jaen C R; Gilchrist V; Stange K C

Publisher

Journal of Healthcare Management

Date

2004
2004-05

Description

Faced with a rapidly changing healthcare environment, primary care practices often have to change how they practice medicine. Yet change is difficult, and the process by which practice improvement can be understood and facilitated has not been well elucidated. Therefore, we developed a model of practice change using data from a quality improvement intervention that was successful in creating a sustainable practice improvement. A multidisciplinary team evaluated data from the Study To Enhance Prevention by Understanding Practice (STEP-UP), a randomized clinical trial conducted to improve the delivery of evidence-based preventive services in 79 northeastern Ohio practices. The team conducted comparative case-study analyses of high- and low-improvement practices to identify variables that are critical to the change process and to create a conceptual model for the change. The model depicts the critical elements for understanding and guiding practice change and emphasizes the importance of these elements' evolving interrelationships. These elements are (1) motivation of key stakeholders to achieve the target for change; (2) instrumental, personal, and interactive resources for change; (3) motivators outside the practice, including the larger healthcare environment and community; and (4) opportunities for change-that is, how key stakeholders understand the change options. Change is influenced by the complex interaction of factors inside and outside the practice. Interventions that are based on understanding the four key elements and their interrelationships can yield sustainable quality improvements in primary care practice.

Subject

Health Care Sciences & Services; behavior; physicians; health-care; rates; impact; sites; policy; clinical-practice; preventive service delivery

Identifier

n/a

Format

Journal Article or Conference Abstract Publication

URL Address

n/a

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

155-168

Issue

3

Volume

49

Citation

Cohen D; McDaniel R R; Crabtree B F; Ruhe M C; Weyer S M; Tallia A; Miller W L; Goodwin M A; Nutting P; Solberg L I; Zyzanski S J; Jaen C R; Gilchrist V; Stange K C, “A practice change model for quality improvement in primary care practice,” NEOMED Bibliography Database, accessed March 3, 2021, https://neomed.omeka.net/items/show/8964.

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