A Taxonomy for External Support for Practice Transformation.

Communication Humans Primary Health Care Quality Improvement Research Personnel
Change Management Delivery of Health Care Diffusion of Innovation Implementation Science Organizational Innovation Primary Health Care Quality Improvement

Journal

Journal of the American Board of Family Medicine : JABFM
ISSN: 1558-7118
Titre abrégé: J Am Board Fam Med
Pays: United States
ID NLM: 101256526

Informations de publication

Date de publication:
Historique:
entrez: 16 1 2021
pubmed: 17 1 2021
medline: 1 9 2021
Statut: ppublish

Résumé

There is no commonly accepted comprehensive framework for describing the practical specifics of external support for practice change. Our goal was to develop such a taxonomy that could be used by both external groups or researchers and health care leaders. The leaders of 8 grants from Agency for Research and Quality for the EvidenceNOW study of improving cardiovascular preventive services in over 1500 primary care practices nationwide worked collaboratively over 18 months to develop descriptions of key domains that might comprehensively characterize any external support intervention. Combining literature reviews with our practical experiences in this initiative and past work, we aimed to define these domains and recommend measures for them. The taxonomy includes 1 domain to specify the conceptual model(s) on which an intervention is built and another to specify the types of support strategies used. Another 5 domains provide specifics about the dose/mode of that support, the types of change process and care process changes that are encouraged, and the degree to which the strategies are prescriptive and standardized. A model was created to illustrate how the domains fit together and how they would respond to practice needs and reactions. This taxonomy and its use in more consistently documenting and characterizing external support interventions should facilitate communication and synergies between 3 areas (quality improvement, practice change research, and implementation science) that have historically tended to work independently. The taxonomy was designed to be as useful for practices or health systems managing change as it is for research.

Sections du résumé

BACKGROUND
There is no commonly accepted comprehensive framework for describing the practical specifics of external support for practice change. Our goal was to develop such a taxonomy that could be used by both external groups or researchers and health care leaders.
METHODS
The leaders of 8 grants from Agency for Research and Quality for the EvidenceNOW study of improving cardiovascular preventive services in over 1500 primary care practices nationwide worked collaboratively over 18 months to develop descriptions of key domains that might comprehensively characterize any external support intervention. Combining literature reviews with our practical experiences in this initiative and past work, we aimed to define these domains and recommend measures for them.
RESULTS
The taxonomy includes 1 domain to specify the conceptual model(s) on which an intervention is built and another to specify the types of support strategies used. Another 5 domains provide specifics about the dose/mode of that support, the types of change process and care process changes that are encouraged, and the degree to which the strategies are prescriptive and standardized. A model was created to illustrate how the domains fit together and how they would respond to practice needs and reactions.
CONCLUSIONS
This taxonomy and its use in more consistently documenting and characterizing external support interventions should facilitate communication and synergies between 3 areas (quality improvement, practice change research, and implementation science) that have historically tended to work independently. The taxonomy was designed to be as useful for practices or health systems managing change as it is for research.

Identifiants

DOI: 10.3122/jabfm.2021.01.200225 PMID: 33452080 PMC: PMC9190131
pubmed: 33452080
pii: 34/1/32
doi: 10.3122/jabfm.2021.01.200225
pmc: PMC9190131
mid: NIHMS1813857
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

32-39

Subventions

Organisme : NCATS NIH HHS
ID : UL1 TR002649
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023921
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023913
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023922
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023912
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023908
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS023940
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023919
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023904
Pays : United States

Informations de copyright

© Copyright 2021 by the American Board of Family Medicine.

Déclaration de conflit d'intérêts

Conflict of interest: None.

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Auteurs

Leif I Solberg (LI)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN). leif.i.solberg@healthpartners.com.

Anton Kuzel (A)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Michael L Parchman (ML)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Donna R Shelley (DR)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

W Perry Dickinson (WP)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Theresa L Walunas (TL)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Ann M Nguyen (AM)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Lyle J Fagnan (LJ)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Samuel Cykert (S)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Deborah J Cohen (DJ)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Bijal A Balasubramanaian (BA)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Douglas Fernald (D)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Leah Gordon (L)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Abel Kho (A)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Alex Krist (A)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

William Miller (W)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Carolyn Berry (C)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Daniel Duffy (D)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

Zsolt Nagykaldi (Z)

From Health Partners Institute, Minneapolis, MN (LIS); Virginia Commonwealth University, Richmond, VA (AKu, AKr); Kaiser Permanente Washington Health Research Institute, Seattle, WA (MLP); School of Global Public Health, New York University (NYU), New York, NY (DRS); University of Colorado, Aurora, CO (WPD, DF); Feinberg School of Medicine, Northwestern University, Chicago, IL (TLW, AKh); NYU Langone Health, New York NY, (AMN, CB); Oregon Health Sciences University, Portland, OR (LRF, DJC, LG); University of North Carolina at Chapel Hill, Chapel Hill, NC (SC); School of Public Health, UTHealth, Dallas, TX (BAB); Lehigh Valley Health Center, Easton, PA (WM); University of Oklahoma, Oklahoma City, OK (DD, ZN).

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Classifications MeSH

questionsmedicales.fr › Sciences de l'information › Communication › A Taxonomy for External Support for Practice...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A Taxonomy for External Support for Practice...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › A Taxonomy for External Support for Practice...
questionsmedicales.fr › Administration des services de santé › Amélioration de la qualité › A Taxonomy for External Support for Practice...
questionsmedicales.fr › Personnes › Groupes professionnels › Personnel de recherche › A Taxonomy for External Support for Practice...