Oregon Rural Practice-based Research Network (ORPRN), Portland, Oregon
Department of Medicine and Center for Health Information Partnerships, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Ann Fam Med. 2018 Apr;16(Suppl 1):S72-S79. doi: 10.1370/afm.2199.
The methods and costs to enroll small primary care practices in large, regional quality improvement initiatives are unknown. We describe the recruitment approach, cost, and resources required to recruit and enroll 500 practices in the Northwest and Midwest regional cooperatives participating in the Agency for Healthcare Research and Quality (AHRQ)-funded initiative, EvidenceNOW: Advancing Heart Health in Primary Care.
The project management team of each cooperative tracked data on recruitment methods used for identifying and connecting with practices. We developed a cost-of-recruitment template and used it to record personnel time and associated costs of travel and communication materials.
A total of 3,669 practices were contacted during the 14- to 18-month recruitment period, resulting in 484 enrolled practices across the 6 states served by the 2 cooperatives. The average number of interactions per enrolled practice was 7, with a total of 29,100 hours and a total cost of $2.675 million, or $5,529 per enrolled practice. Prior partnerships predicted recruiting almost 1 in 3 of these practices as contrasted to 1 in 20 practices without a previous relationship or warm hand-off.
Recruitment of practices for large-scale practice quality improvement transformation initiatives is difficult and costly. The cost of recruiting practices without existing partnerships is expensive, costing 7 times more than reaching out to familiar practices. Investigators initiating and studying practice quality improvement initiatives should budget adequate funds to support high-touch recruitment strategies, including building trusted relationships over a long time frame, for a year or more.
将小型初级保健实践纳入大型区域质量改进计划的方法和成本尚不清楚。我们描述了招募方法、成本和资源，以招募和纳入参与美国医疗保健研究与质量局（AHRQ）资助的倡议——“现在就改善初级保健中的心脏健康”（EvidenceNOW）的西北和中西部地区合作组织的 500 家实践。
每个合作组织的项目管理团队都跟踪了用于识别和联系实践的招募方法的数据。我们开发了一个招募成本模板，并使用它来记录人员时间以及旅行和沟通材料的相关成本。
在 14 至 18 个月的招募期间，共联系了 3669 家实践，在 2 个合作组织服务的 6 个州共纳入了 484 家实践。每个已注册实践的平均互动次数为 7 次，共 29100 小时，总成本为 267.5 万美元，即每个已注册实践 5529 美元。先前的合作关系预测，与没有先前关系或没有热身交接的实践相比，几乎可以招募到其中 1/3 的实践。
为大规模实践质量改进转型计划招募实践是困难和昂贵的。没有现有伙伴关系的实践的招募成本非常昂贵，是接触熟悉实践的成本的 7 倍。启动和研究实践质量改进计划的研究人员应该为支持高接触度的招募策略预算充足的资金，包括在长达一年或更长时间内建立长期信任关系。
