scholarly journals Clinician Perspectives on the Benefits of Practice Facilitation for Small Primary Care Practices

2019 ◽  
Vol 17 (Suppl 1) ◽  
pp. S17-S23 ◽  
Author(s):  
Erin S. Rogers ◽  
Allison M. Cuthel ◽  
Carolyn A. Berry ◽  
Sue A. Kaplan ◽  
Donna R. Shelley
Keyword(s):  
Primary Care ◽  
Practice Facilitation ◽  
Small Primary ◽  
Clinician Perspectives ◽  
Care Practices ◽  
Primary Care Practices

Small Primary Care Practices Face Four Hurdles—Including A Physician-Centric Mind-Set—In Becoming Medical Homes

2012 ◽  
Vol 31 (11) ◽  
pp. 2417-2422 ◽  
Author(s):  
Paul A. Nutting ◽  
Benjamin F. Crabtree ◽  
Reuben R. McDaniel
Keyword(s):  
Primary Care ◽  
Medical Homes ◽  
Small Primary ◽  
Care Practices ◽  
Mind Set ◽  
Primary Care Practices

scholarly journals The STUN (STop UNhealthy) Alcohol Use Now Trial: Study Protocol for an Adaptive Randomized Trial on Dissemination and Implementation of Screening and Management of Unhealthy Alcohol Use in Primary Care

2021 ◽  
Author(s):  
Daniel E. Jonas ◽  
Colleen Barclay ◽  
Debbie Grammer ◽  
Chris Weathington ◽  
Sarah A. Birken ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Practice Facilitation ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
The Us ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Unhealthy alcohol use is a leading cause of preventable deaths in the US and is associated with many societal and health problems. Less than a third of people who visit primary care providers in the US are asked about or ever discuss alcohol use with a health professional. Methods/design: This study is an adaptive, randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in small-to-medium-sized primary care practices. Study participants will include primary care practices in North Carolina with 10 or fewer providers. All enrolled practices will receive a practice facilitation intervention that includes quality improvement (QI) coaching, electronic health record (EHR) support, training, and expert consultation. After 6 months, practices in the lower 50th percentile (based on performance) will be randomized to continued practice facilitation or provision of telehealth services plus ongoing facilitation for the next 6 months. Practices in the upper 50th percentile after the initial 6 months of intervention will continue to receive practice facilitation alone. The main outcome measures include the number (and %) of patients in the target population who are screened for unhealthy alcohol use, screen positive, and receive brief counseling. Additional measures include the number (and %) of patients who receive pharmacotherapy for AUD or are referred for AUD services.Discussion: A successful intervention would significantly reduce morbidity among adults from unhealthy alcohol use by increasing counseling and other treatment opportunities. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. It will also generate scientific knowledge about whether embedded telehealth services can improve use of evidence-based screening and interventions for practices with slower uptake. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.Trial registration: ClinicalTrials.gov NCT04317989. March 23, 2020 –registered, https://www.clinicaltrials.gov/ct2/show/NCT04317989?titles=STUN&draw=2&rank=1

scholarly journals Medical Home Implementation in Small Primary Care Practices: Provider Perspectives

2016 ◽  
Vol 29 (6) ◽  
pp. 767-774 ◽  
Author(s):  
G. Gimm ◽  
J. Want ◽  
D. Hough ◽  
T. Polk ◽  
M. Rodan ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Provider Perspectives ◽  
Small Primary ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Cost-effectiveness of depression case management in small practices

2013 ◽  
Vol 202 (6) ◽  
pp. 441-446 ◽  
Author(s):  
Jochen Gensichen ◽  
Juliana J. Petersen ◽  
Michael Von Korff ◽  
Dirk Heider ◽  
Steffen Baron ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Case Management ◽  
Controlled Trial ◽  
Cost Effective ◽  
Control Group ◽  
Significant Difference ◽  
Small Primary ◽  
Care Practices ◽  
Primary Care Practices

BackgroundCase management undertaken by healthcare assistants in small primary care practices is effective in improving depression symptoms and adherence in patients with major depression.AimsTo evaluate the cost-effectiveness of depression case management by healthcare assistants in small primary care practices.MethodCost-effectiveness analysis on the basis of a pragmatic randomised controlled trial (2005-2008): practice-based healthcare assistants in 74 practices provided case management to 562 patients with major depression over 1 year. Our primary outcome was the incremental costeffectiveness ratio (ICER) calculated as the ratio of differences in mean costs and mean number of qualityadjusted life-years (QALYs). Our secondary outcome was the mean depression-free days (DFDs) between the intervention and control group at 24-month follow-up. The study was registered at the International Standard Randomised Controlled Trial Number Registry: ISRCTN66386086.ResultsIntervention v. control group: no significant difference in QALYs; significantly more DFDs (mean: 373 v. 311, P<0.01); no significant difference in mean direct healthcare costs (€4495 v. €3506, P = 0.16); considerably lower mean indirect costs (€5228 v. €7539, P = 0.06), resulting in lower total costs (€9723 v. €11 045, P = 0.41). The point estimate for the cost-utility ratio was €38 429 per QALY gained if only direct costs were considered, and ‘dominance’ of the intervention if total costs were considered. Yet, regardless of decision makers' willingness to pay per QALY, the probability of the intervention being cost-effective was never above 90%.ConclusionsIn small primary care practices, 1 year of case management did not increase the number of QALYs but it did increase the number of DFDs. The intervention was likely to be cost-effective.

scholarly journals The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daniel E. Jonas ◽  
Colleen Barclay ◽  
Debbie Grammer ◽  
Chris Weathington ◽  
Sarah A. Birken ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Practice Facilitation ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
The Usa ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background Unhealthy alcohol use is a leading cause of preventable deaths in the USA and is associated with many societal and health problems. Less than a third of people who visit primary care providers in the USA are asked about or ever discuss alcohol use with a health professional. Methods/design This study is an adaptive, randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in small-to-medium-sized primary care practices. Study participants will include primary care practices in North Carolina with 10 or fewer providers. All enrolled practices will receive a practice facilitation intervention that includes quality improvement (QI) coaching, electronic health record (EHR) support, training, and expert consultation. After 6 months, practices in the lower 50th percentile (based on performance) will be randomized to continued practice facilitation or provision of telehealth services plus ongoing facilitation for the next 6 months. Practices in the upper 50th percentile after the initial 6 months of intervention will continue to receive practice facilitation alone. The main outcome measures include the number (and %) of patients in the target population who are screened for unhealthy alcohol use, screen positive, and receive brief counseling. Additional measures include the number (and %) of patients who receive pharmacotherapy for AUD or are referred for AUD services. Sample size calculations determined that 35 practices are needed to detect a 10% increase in the main outcome (percent screened for unhealthy alcohol use) over 6 months. Discussion A successful intervention would significantly reduce morbidity among adults from unhealthy alcohol use by increasing counseling and other treatment opportunities. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. It will also generate scientific knowledge about whether embedded telehealth services can improve the use of evidence-based screening and interventions for practices with slower uptake. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices. Trial registration ClinicalTrials.govNCT04317989. Registered on March 23, 2020.

scholarly journals Coaching Small Primary Care Practices to Use Patient Portals

2019 ◽  
Vol 17 (Suppl 1) ◽  
pp. S83-S83 ◽  
Author(s):  
Lauren Gritzer ◽  
Marsha Davenport ◽  
Michael Dark ◽  
Niharika Khanna
Keyword(s):  
Primary Care ◽  
Patient Portals ◽  
Small Primary ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Improving Quality Improvement Capacity and Clinical Performance in Small Primary Care Practices

2021 ◽  
Vol 19 (6) ◽  
pp. 499-506
Author(s):  
Katie F. Coleman ◽  
Chloe Krakauer ◽  
Melissa Anderson ◽  
LeAnn Michaels ◽  
David A. Dorr ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Clinical Performance ◽  
Small Primary ◽  
Care Practices ◽  
Primary Care Practices
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