Quality improvement in small office settings: an examination of successful practices
Open Access
- 9 February 2009
- journal article
- Published by Springer Nature in BMC Family Practice
- Vol. 10 (1) , 14
- https://doi.org/10.1186/1471-2296-10-14
Abstract
Background Physicians in small to moderate primary care practices in the United States (U.S.) (<25 physicians) face unique challenges in implementing quality improvement (QI) initiatives, including limited resources, small staffs, and inadequate information technology systems 23,36. This qualitative study sought to identify and understand the characteristics and organizational cultures of physicians working in smaller practices who are actively engaged in measurement and quality improvement initiatives. Methods We undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39) that used performance data to drive quality improvement activities. Results Physicians indicated that benefits to performing measurement and QI included greater practice efficiency, patient and staff retention, and higher staff and clinician satisfaction with practice. Internal facilitators included the designation of a practice champion, cooperation of other physicians and staff, and the involvement of practice leaders. Time constraints, cost of activities, problems with information management and or technology, lack of motivated staff, and a lack of financial incentives were commonly reported as barriers. Conclusion These findings shed light on how physicians engage in quality improvement activities, and may help raise awareness of and aid in the implementation of future initiatives in small practices more generally.Keywords
This publication has 38 references indexed in Scilit:
- Measuring performance and missing the point?BMJ, 2007
- Assessing the Influence of Incentives on Physicians and Medical GroupsMedical Care Research and Review, 2004
- Health promotion in physician organizations: Results from a national studyAmerican Journal of Preventive Medicine, 2004
- Physicians’ Use Of Electronic Medical Records: Barriers And SolutionsHealth Affairs, 2004
- Paying For Quality: Providers’ Incentives For Quality ImprovementHealth Affairs, 2004
- Quality collaboratives: lessons from researchQuality and Safety in Health Care, 2002
- Improving Chronic Illness Care: Translating Evidence Into ActionHealth Affairs, 2001
- Local opinion leaders: effects on professional practice and health care outcomesPublished by Wiley ,1999
- THE FIFTH DISCIPLINEMeasuring Business Excellence, 1997
- Theory unmasked: The uses and guises of theory in qualitative researchResearch in Nursing & Health, 1993