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J Am Board Fam Med. 2011 Jul-Aug;24(4):360-9. doi: 10.3122/jabfm.2011.04.100101.

How eight primary care practices initiated and maintained quality monitoring and reporting.

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  • 1Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599-7595, USA. psloane@med.unc.edu

Abstract

BACKGROUND:

Primary care medical practices increasingly are asked by payers, employers, and government agencies to report quality data, but the process of doing so is not well delineated.

METHODS:

Providers and office staff in a diverse sample of eight primary care practices in North Carolina comprised this study population. Interviews were conducted and self-administered questionnaires were disseminated in practices that were successfully reporting data to one or more of 4 reporting programs. Our measures included responses to open-ended and Likert scale questions about experiences and potential facilitators and barriers, as well as subscales of the Practice Assessment tool and the Culture of Group Practices instrument.

RESULTS:

Study practices had stronger change histories, higher information and quality emphases, and lower business emphases than historical comparison practices. Motivation to participate, a leader who catalyzes the process, and establishment of new systems characterized successful practices. Staff time, information technology challenges, and resistance from some providers were common barriers. Practices achieve a sustainability state when numerous barriers have been successfully overcome and tangible results achieved from the process.

CONCLUSIONS:

Implementing and sustaining quality reporting requires a complex set of motivators, facilitators, and strategies to overcome inherent barriers that can present themselves in practices that seek to implement changes in this direction.

[PubMed - indexed for MEDLINE]
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