Recruiting Practices for Change Initiatives Is Hard: Findings From EvidenceNOW

Abstract

Engaging primary care practices in initiatives designed to enhance quality, reduce costs, and promote safety is challenging as practices are already participating in numerous projects and mandated programs designed to improve care delivery and quality. Recruiters must expand their recruitment tools to engage today's practices in quality improvement. Using grant proposals, online diaries, observational site visits, and interviews with key stakeholders, the authors identify successful practice recruitment strategies in the EvidenceNOW initiative, which aimed to recruit approximately 1500 small- to medium-sized primary care practices. Recruiters learned they needed to articulate how participation in EvidenceNOW aligned with other initiatives and could help practices succeed with federal and state initiatives, recognition programs, and existing or future payment requirements. Recruiters, initiative leaders, and funders must now consider how their efforts align with ongoing initiatives to successfully recruit and engage practices, ease practice burden, and encourage participation in efforts that support practice transformation.

Study protocol for evaluating Six Building Blocks for opioid management implementation in primary care practices

“…Brief screening calls were held with interested organizations to provide them with more information about the study and explain expectations for participation and to gather information about the organization's motivation for participation, past experience with similar QI initiatives, goals and expectations, and use of electronic health record (EHR) system for QI and expected vendor changes in the near future. These calls helped forge relationships with potential participating organizations and assess study alignment with their organizational goals-two strategies identified as important for facilitating health care QI initiative recruitment [21,22].…”

Data-Driven Diffusion Of Innovations: Successes And Challenges In 3 Large-Scale Innovative Delivery Models

“…The three innovations were accountable care organizations (ACOs), advanced primary care practice models, 15 and EvidenceNOW. 16 ACOs, administered by the Centers for Medicare and Medicaid Services (CMS) through the Center for Medicare and Medicaid Innovation (CMMI) as well as by commercial payers, are large groups of health care organizations and practitioners who receive incentives to manage both the quality and total cost of care. With these incentives and their size, ACOs use data to drive the diffusion of innovations such as programs to reduce avoidable emergency department (ED) visits and hospitalizations.…”

“…Finally, EvidenceNOW, a large effort to transform quality improvement run by regional cooperatives and funded by the Agency for Healthcare Research and Quality, 15,16 focuses on increasing the use of cardiovascular preventive services among small and medium-size primary care practices having limited experience with quality improvement methods. 15 The cooperatives, similar to primary care extension agents, 17 provide technical and educational tools and other resources to help practices improve their patients' heart health.…”

Reflections From a Statistical Editor: Elements of Great Manuscripts

“…5 As such, in cluster randomized trials, it is rare to see studies with a large enough sample of practices for simple randomization to yield appropriate balance in observed and unobserved confounders between study groups-simple randomization mostly works with large samples. Many primary care researchers smartly circumvent this limitation by performing stratified or block randomization, schemes that force confounding factors to be balanced between study groups.…”