Implementing quality improvement into practice: Exploring the work to develop and implement a QI project in primary care Article Swipe

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Eric M. Wiedenman , L.F. Eastman , Claudia del C. Gutiérrez-Torres , Sanja Kostov , Roseanne O. Yeung ·

YOU? · · 2024 · Open Access · · DOI: https://doi.org/10.1370/afm.22.s1.6381

CONTEXT: The College of Physicians and Surgeons of Alberta launched the Physician Practice Improvement Program in 2021 requiring physicians to incorporate one personal development and two quality improvement (QI) activities into their practice over a continuous five-year cycle. Physicians receive little QI training in their formal education and require professional development opportunities to learn necessary QI training and skills. This presentation explores the work to implement a practice-driven QI project, what resources and education was needed, and what constraints exist for primary care physicians to conduct QI. OBJECTIVE: The purpose of this study was to explore what is required to conduct QI work, the supports and resources necessary, and perceptions of QI prioritization to improve healthcare. STUDY DESIGN AND ANALYSIS: Interviews and focus groups were conducted with the physicians who co-led the project, resident physicians and staff who participated in QI training for the project, resident physicians who assisted in project implementation and reporting, and content experts in QI in healthcare. Questions were developed using the normalization process theory (NPT) to explore the social organization of the work and necessary activities in development and implementation of the project, and the interactive process framework (IPF) to explore the non-linear and dynamic nature of the real-world implementation. Transcripts were coded deductively using the NPT and IPF constructs, with additional codes developed inductively using reflexive thematic analysis. Analysis meetings with co-investigators resolved any disagreements in coding for each transcript and developed code consensus. RESULTS: Key themes were needing additional QI training and project support, reliance on resident physicians and clinic staff to assist in implementation, and the constraints on physicians to complete QI work. CONCLUSIONS: This project highlights work and time required to conduct quality QI projects in practice, the supports and structures necessary for this work, and the variance in QI support and structure across health systems in Alberta. In response to training and support needs, project co-leads developed a more comprehensive QI course with mentorship and support for ongoing QI project development and implementation. The challenges and constraints faced by the motivated physicians of this project to implement QI in practice provide important context for QI work.

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Operations Management

Family Medicine

Epistemology

Philosophy

Mechanical Engineering

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Primary care Work (physics) Quality management Quality (philosophy) Medical education Process management Psychology Nursing Medicine Engineering management Computer science Knowledge management Engineering Operations management Family medicine Epistemology Philosophy Management system Mechanical engineering

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Type: article
Language: en
Landing Page: https://doi.org/10.1370/afm.22.s1.6381
PDF: https://www.annfammed.org/content/annalsfm/22/Supplement_1/6381.full.pdf
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OpenAlex ID: https://openalex.org/W4404808675

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DOI: https://doi.org/10.1370/afm.22.s1.6381

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Title: Implementing quality improvement into practice: Exploring the work to develop and implement a QI project in primary care

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Type: article

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Language: en

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Publication year: 2024

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Publication date: 2024-11-20

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Authors: Eric M. Wiedenman, L.F. Eastman, Claudia del C. Gutiérrez-Torres, Sanja Kostov, Roseanne O. Yeung

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Landing page: https://doi.org/10.1370/afm.22.s1.6381

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Concepts: Primary care, Work (physics), Quality management, Quality (philosophy), Medical education, Process management, Psychology, Nursing, Medicine, Engineering management, Computer science, Knowledge management, Engineering, Operations management, Family medicine, Epistemology, Philosophy, Management system, Mechanical engineering

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abstract_inverted_index.social	173
abstract_inverted_index.themes	242
abstract_inverted_index.theory	168
abstract_inverted_index.Alberta	8
abstract_inverted_index.College	2
abstract_inverted_index.Program	14
abstract_inverted_index.conduct	85, 100, 280
abstract_inverted_index.content	155
abstract_inverted_index.context	352
abstract_inverted_index.dynamic	199
abstract_inverted_index.experts	156
abstract_inverted_index.explore	95, 171, 195
abstract_inverted_index.improve	114
abstract_inverted_index.needed,	75
abstract_inverted_index.needing	244
abstract_inverted_index.ongoing	327
abstract_inverted_index.primary	81
abstract_inverted_index.process	167, 191
abstract_inverted_index.project	150, 249, 273, 314, 329, 344
abstract_inverted_index.provide	350
abstract_inverted_index.purpose	89
abstract_inverted_index.quality	26, 281
abstract_inverted_index.receive	39
abstract_inverted_index.require	48
abstract_inverted_index.skills.	58
abstract_inverted_index.support	299, 312, 325
abstract_inverted_index.systems	304
abstract_inverted_index.Alberta.	306
abstract_inverted_index.Analysis	224
abstract_inverted_index.CONTEXT:	0
abstract_inverted_index.Practice	12
abstract_inverted_index.RESULTS:	240
abstract_inverted_index.Surgeons	6
abstract_inverted_index.assisted	148
abstract_inverted_index.co-leads	315
abstract_inverted_index.complete	268
abstract_inverted_index.explores	61
abstract_inverted_index.launched	9
abstract_inverted_index.meetings	225
abstract_inverted_index.personal	22
abstract_inverted_index.practice	32, 349
abstract_inverted_index.project,	69, 132, 144, 187
abstract_inverted_index.projects	283
abstract_inverted_index.reliance	251
abstract_inverted_index.required	98, 278
abstract_inverted_index.resident	133, 145, 253
abstract_inverted_index.resolved	228
abstract_inverted_index.response	308
abstract_inverted_index.support,	250
abstract_inverted_index.supports	104, 287
abstract_inverted_index.thematic	222
abstract_inverted_index.training	42, 56, 141, 247, 310
abstract_inverted_index.variance	296
abstract_inverted_index.ANALYSIS:	119
abstract_inverted_index.Physician	11
abstract_inverted_index.Questions	161
abstract_inverted_index.analysis.	223
abstract_inverted_index.conducted	125
abstract_inverted_index.developed	163, 218, 237, 316
abstract_inverted_index.education	46, 73
abstract_inverted_index.five-year	36
abstract_inverted_index.framework	192
abstract_inverted_index.implement	65, 346
abstract_inverted_index.important	351
abstract_inverted_index.motivated	340
abstract_inverted_index.necessary	54, 179, 290
abstract_inverted_index.practice,	285
abstract_inverted_index.reflexive	221
abstract_inverted_index.requiring	17
abstract_inverted_index.resources	71, 106
abstract_inverted_index.structure	301
abstract_inverted_index.Interviews	120
abstract_inverted_index.OBJECTIVE:	87
abstract_inverted_index.Physicians	4, 38
abstract_inverted_index.activities	29, 180
abstract_inverted_index.additional	216, 245
abstract_inverted_index.challenges	334
abstract_inverted_index.consensus.	239
abstract_inverted_index.continuous	35
abstract_inverted_index.highlights	274
abstract_inverted_index.mentorship	323
abstract_inverted_index.necessary,	107
abstract_inverted_index.non-linear	197
abstract_inverted_index.physicians	18, 83, 128, 134, 146, 254, 266, 341
abstract_inverted_index.real-world	203
abstract_inverted_index.reporting,	153
abstract_inverted_index.structures	289
abstract_inverted_index.transcript	235
abstract_inverted_index.Improvement	13
abstract_inverted_index.Transcripts	205
abstract_inverted_index.constraints	78, 264, 336
abstract_inverted_index.constructs,	214
abstract_inverted_index.deductively	208
abstract_inverted_index.development	23, 50, 182, 330
abstract_inverted_index.healthcare.	115, 160
abstract_inverted_index.improvement	27
abstract_inverted_index.incorporate	20
abstract_inverted_index.inductively	219
abstract_inverted_index.interactive	190
abstract_inverted_index.perceptions	109
abstract_inverted_index.CONCLUSIONS:	271
abstract_inverted_index.organization	174
abstract_inverted_index.participated	138
abstract_inverted_index.presentation	60
abstract_inverted_index.professional	49
abstract_inverted_index.comprehensive	319
abstract_inverted_index.disagreements	230
abstract_inverted_index.normalization	166
abstract_inverted_index.opportunities	51
abstract_inverted_index.implementation	151, 184
abstract_inverted_index.prioritization	112
abstract_inverted_index.implementation,	261
abstract_inverted_index.implementation.	204, 332
abstract_inverted_index.practice-driven	67
abstract_inverted_index.co-investigators	227
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countries_distinct_count	0
institutions_distinct_count	5
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