From Kaiser Permanente of Washington Health Research Institute, Seattle WA (MLP, MLA, RBP, EA); Department of Medicine, Oregon Health Sciences University, Portland OR (DAR).
J Am Board Fam Med. 2020 Jul-Aug;33(4):620-625. doi: 10.3122/jabfm.2020.04.190369.
To assess whether primary care practices with and without support from a larger organization differ in their ability to produce timely reports on cardiovascular disease quality measures.
Although many primary care practices are now part of larger organizations, it is not clear whether such a shift will improve the ability of those who work in these primary care settings to easily access and use their own data for improvement.
Smaller primary care practices were enrolled in a trial of external practice support to build quality improvement (QI) capacity. A request for clinical quality measure (eCQM) data were sent to each practice and study outcomes were defined based on the date on which practices first submitted valid data for at least 1 of the 3 measures. A practice survey completed by a clinic manager captured practice characteristics, including the presence of QI support from a larger organization.
Of the 209 enrolled practices, 205 had complete data for analysis. Practices without central QI support had higher rates of eCQM submission at 30 days (38% vs 20%) and 60 days, (63% vs 48%) than practices with central QI support. Practices with central QI support took longer to submit data (median, 57 days) compared with practices without centralized support (median, 40 days) although this difference was not significant.
The ability of smaller practices without centralized QI support to report their eCQMs more quickly may have implications for their subsequent ability to improve these measures.
评估是否有较大组织支持的初级保健实践在及时报告心血管疾病质量措施方面存在差异。
尽管许多初级保健实践现在都属于较大的组织，但尚不清楚这种转变是否会提高在这些初级保健环境中工作的人员轻松访问和使用自己数据进行改进的能力。
较小的初级保健实践参加了一项外部实践支持试验，以建立质量改进（QI）能力。向每个实践发送了临床质量措施（eCQM）数据请求，研究结果是根据实践首次提交至少 3 项措施中的 1 项有效数据的日期来定义的。诊所经理完成的实践调查收集了实践特征，包括是否有较大组织提供的 QI 支持。
在 209 个入组实践中，有 205 个实践具有完整的分析数据。没有中央 QI 支持的实践在 30 天（38%比 20%）和 60 天（63%比 48%）提交 eCQM 的比例更高。虽然差异无统计学意义，但具有中央 QI 支持的实践提交数据的中位数（57 天）长于没有集中支持的实践（中位数 40 天）。
没有中央 QI 支持的较小实践更快地报告其 eCQM 的能力可能对其随后改善这些措施的能力产生影响。
