The Northwest Coalition for Primary Care Practice Support

NCT02839382 | Completed

• 1 other identifier: AHRQ 1R8HS023908-01
• Study Type: interventional
• Target: 209
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this project is to build capacity for quality improvement (QI) in small primary care practices across Washington, Oregon and Idaho by improving risk factors for heart attacks such as blood pressure, cholesterol and smoking. The Northwest Coalition for Primary Care Practice Support will assist practices by providing them with a QI coach, creating group learning opportunities, and conducting educational outreach activities. An innovative study design will be used to determine what levels and types of support are most helpful and effective.

Conditions

Cardiovascular Disease; Essential Hypertension; Nicotine Dependence; Hyperlipidemia

Outcome Measures

Primary Outcomes (3)

• Appropriate use of Aspirin

  National Quality Forum (NQF) 0068 Ischemic Vascular Disease (IVD): Use of Aspirin or another Antithrombotic

  Every 3 months with 12 month look-back

• Hypertension

  NQF 0018 Controlling hypertension

  Every 3 months with 12 month look-back

• Smoking

  NQF 0027 Smoking and Tobacco Use Cessation, Medical Assistance

  Every 3 months with 12 month look-back

Secondary Outcomes (2)

• Change Process Capacity

  Baseline, 15 months, 21 months

• Quality Improvement Capacity Assessment

  Baseline and 12 months

Study Arms (4)

Coaching

ACTIVE COMPARATOR

External facilitation by a practice coach for 15 months

Other: Coaching

Educational Outreach

ACTIVE COMPARATOR

Academic detailing phone calls to support implementation of a cardiovascular risk calculator/estimator in each clinic

Other: Coaching; Other: Educational Outreach

Site Visit

ACTIVE COMPARATOR

Site visits made by practices to 'exemplar" practices to learn innovative approaches to quality improvement

Other: Coaching; Other: Site Visits

Educational Outreach and Site Visit

ACTIVE COMPARATOR

In this arm of the study, practices will be offered both educational outreach and an opportunity for a site visit

Other: Coaching; Other: Educational Outreach; Other: Site Visits

Interventions

Coaching OTHER

An external facilitator or coach is assigned 15-20 primary care clinics and will make face-to-face site visits and monthly phone calls for 15 months to support building QI capacity in each assigned practcie

Also known as: Practice Facilitation

Coaching; Educational Outreach; Educational Outreach and Site Visit; Site Visit

Educational Outreach OTHER

Practices randomized to this arm of the study will receive an educational outreach phone call by an academic expert on implementation strategies for use of a cardiovascular risk calculator within their daily work flow and clinic setting

Also known as: Academic Detailing

Educational Outreach; Educational Outreach and Site Visit

Site Visits OTHER

Practices randomized to this arm of the study will be given an opportunity to make a site visit to an "exemplar" practice to learn about innovative approaches to conducting quality improvement activities.

Also known as: Peer-to-peer learning

Educational Outreach and Site Visit; Site Visit

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Primary care practice with 10 or fewer providers and an Electronic Health Record (EHR) that meets Stage 1 meaningful use criteria

You may not qualify if:

• No EHR

Sponsors & Collaborators

• Kaiser Permanente: lead
• University of Washington: collaborator
• Oregon Health and Science University: collaborator
• Qualis Health: collaborator

Study Sites (1)

GroupHealthCoop

Seattle, Washington, 98101, United States

Location

Related Publications (6)

• Parchman ML, Fagnan LJ, Dorr DA, Evans P, Cook AJ, Penfold RB, Hsu C, Cheadle A, Baldwin LM, Tuzzio L. Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care. Implement Sci. 2016 Oct 13;11(1):138. doi: 10.1186/s13012-016-0502-7.

  PMID: 27737719 BACKGROUND

• Fagnan LJ, Walunas TL, Parchman ML, Dickinson CL, Murphy KM, Howell R, Jackson KL, Madden MB, Ciesla JR, Mazurek KD, Kho AN, Solberg LI. Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment? Ann Fam Med. 2018 Apr;16(Suppl 1):S72-S79. doi: 10.1370/afm.2199.

  PMID: 29632229 BACKGROUND

• Baldwin LM, Fischer MA, Powell J, Holden E, Tuzzio L, Fagnan LJ, Hummel J, Parchman ML. Virtual Educational Outreach Intervention in Primary Care Based on the Principles of Academic Detailing. J Contin Educ Health Prof. 2018 Fall;38(4):269-275. doi: 10.1097/CEH.0000000000000224. No abstract available.

  PMID: 30346338 BACKGROUND

• Tuzzio L, O'Meara ES, Holden E, Parchman ML, Ralston JD, Powell JA, Baldwin LM. Barriers to Implementing Cardiovascular Risk Calculation in Primary Care: Alignment With the Consolidated Framework for Implementation Research. Am J Prev Med. 2021 Feb;60(2):250-257. doi: 10.1016/j.amepre.2020.07.027. Epub 2020 Dec 3.

  PMID: 33279368 DERIVED

• Parchman ML, Anderson ML, Penfold RB, Kuo E, Dorr DA. The Ability of Practices to Report Clinical Quality Measures: More Evidence of the Size Paradox? J Am Board Fam Med. 2020 Jul-Aug;33(4):620-625. doi: 10.3122/jabfm.2020.04.190369.

  PMID: 32675274 DERIVED

• Parchman ML, Anderson ML, Coleman K, Michaels LA, Schuttner L, Conway C, Hsu C, Fagnan LJ. Assessing quality improvement capacity in primary care practices. BMC Fam Pract. 2019 Jul 25;20(1):103. doi: 10.1186/s12875-019-1000-1.

  PMID: 31345167 DERIVED

MeSH Terms

Conditions

Cardiovascular Diseases; Essential Hypertension; Tobacco Use Disorder; Hyperlipidemias

Condition Hierarchy (Ancestors)

Hypertension; Vascular Diseases; Substance-Related Disorders; Chemically-Induced Disorders; Mental Disorders; Dyslipidemias; Lipid Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Study Officials

• Michael L Parchman, MD

  Kaiser Permanente

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 18, 2016
• First Posted: July 21, 2016
• Study Start: May 1, 2015
• Primary Completion: May 1, 2018
• Study Completion: May 1, 2018
• Last Updated: September 16, 2019

Record last verified: 2019-09

Data Sharing

• IPD Sharing: Will share

Locations

US (1)