School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
Department of Cardiology, Concord Hospital, ANZAC Research Institute, Sydney, Australia.
PLoS One. 2024 Jun 4;19(6):e0298777. doi: 10.1371/journal.pone.0298777. eCollection 2024.
This study evaluates primary care practices' engagement with various features of a quality improvement (QI) intervention for patients with coronary heart disease (CHD) in four Australian states.
Twenty-seven practices participated in the QI intervention from November 2019 -November 2020. A combination of surveys, semi-structured interviews and other materials within the QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease (QUEL) study were used in the process evaluation. Data were summarised using descriptive statistical and thematic analyses for 26 practices.
Sixty-four practice team members and Primary Health Networks staff provided feedback, and nine of the 63 participants participated in the interviews. Seventy-eight percent (40/54) were either general practitioners or practice managers. Although 69% of the practices self-reported improvement in their management of heart disease, engagement with the intervention varied. Forty-two percent (11/26) of the practices attended five or more learning workshops, 69% (18/26) used Plan-Do-Study-Act cycles, and the median (Interquartile intervals) visits per practice to the online SharePoint site were 170 (146-252) visits. Qualitative data identified learning workshops and monthly feedback reports as the key features of the intervention.
Practice engagement in a multi-featured data-driven QI intervention was common, with learning workshops and monthly feedback reports identified as the most useful features. A better understanding of these features will help influence future implementation of similar interventions.
Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134.
本研究评估了澳大利亚四个州的初级保健实践在参与冠心病（CHD）患者质量改进（QI）干预的各种特征方面的情况。
27 家实践参加了 2019 年 11 月至 2020 年 11 月的 QI 干预。QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease（QUEL）研究使用了问卷调查、半结构化访谈和其他材料进行过程评估。对于 26 家实践，使用描述性统计和主题分析对数据进行了总结。
64 名实践团队成员和初级卫生网络工作人员提供了反馈，63 名参与者中有 9 名参加了访谈。78%（40/54）为全科医生或实践经理。尽管 69%的实践报告在心脏病管理方面有所改善，但对干预措施的参与程度有所不同。42%（11/26）的实践参加了五次或更多的学习研讨会，69%（18/26）使用了计划-执行-研究-行动循环，每个实践访问在线 SharePoint 网站的中位数（四分位间距）为 170（146-252）次。定性数据确定学习研讨会和每月反馈报告是干预的关键特征。
实践对多特征数据驱动的 QI 干预的参与是常见的，学习研讨会和每月反馈报告被认为是最有用的特征。更好地了解这些特征将有助于影响未来类似干预措施的实施。
澳大利亚新西兰临床试验注册（ANZCTR）编号 ACTRN12619001790134。
