48 Participants Needed

CQI Cohorts for Primary Care Improvement

Recruiting at 17 trial locations
EM
Overseen ByElisabeth Martin, Ph.D(c)
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Université de Sherbrooke
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Audit and Feedback, Quality Improvement Strategy, Performance Feedback, Clinical Audit, CQI intervention, Continuous Quality Improvement, Quality Improvement Intervention?

Research shows that continuous quality improvement (CQI) interventions can help improve health outcomes, such as better blood sugar control in diabetes patients, by enhancing the quality of care in primary care settings.12345

Is the CQI intervention generally safe for humans?

The research articles provided do not contain specific information about the safety of CQI interventions in humans.13467

How is the CQI intervention treatment different from other treatments for primary care improvement?

The CQI intervention is unique because it focuses on continuously improving the quality of care in primary care settings by involving the entire healthcare team in a systematic process of evaluating and enhancing practice management, rather than targeting a specific medical condition or using a medication.12489

What is the purpose of this trial?

The goal of this clinical trial is to compare the implementation and effects of CQI cohorts on AA for PHC clinics. The main questions it aims to answer are to assess the effectiveness of CQI cohorts on AA outcomes.

Research Team

MB

Mylaine Breton, PhD

Principal Investigator

Université de Sherbrooke

Eligibility Criteria

This trial is for primary healthcare clinics where at least half of the team agrees to participate. The clinic must provide care from a variety of health professionals, not just doctors and nurses. Solo practice physicians or clinics with only physician-nurse models cannot join.

Inclusion Criteria

Clinics must offer interprofessional care
At least 50% of all team members should accept to take part in the study

Exclusion Criteria

Solo Practice Physicians
Physician-nurse only model

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

PHC teams participate in an externally facilitated CQI program focusing on advanced access, consisting of interprofessional reflective sessions, group mentoring, and cohort cross-learning exchange opportunities.

18 months

Control Group Audit

Clinics in the control group receive feedback on six key advanced access indicators and patient-reported experiences about access.

12-18 months

Follow-up

Participants are monitored for outcomes such as the delay before the 3rd next available appointment, relational continuity, and use of walk-in services.

18 months

Treatment Details

Interventions

  • Audit and Feedback
  • CQI intervention
Trial Overview The study is examining how effective Continuous Quality Improvement (CQI) cohorts are in improving access to primary healthcare services. It involves monitoring performance (audit) and providing feedback, alongside CQI interventions.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: CQI interventionExperimental Treatment1 Intervention
The proposed CQI cohort consists of three activities carried out iteratively until the improvement objectives are achieved.
Group II: Audit and feedbackActive Control1 Intervention
Clinics in the control group will receive feedback on six key AA indicators, patients reported experience about access and selected AA processes.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Université de Sherbrooke

Lead Sponsor

Trials
317
Recruited
79,300+

Isabelle Gaboury

Collaborator

Trials
1
Recruited
50+

Mike Green

Collaborator

Trials
1
Recruited
50+

Tara Kiran

Collaborator

Trials
1
Recruited
50+

Janusz Kaczorowski

Collaborator

Trials
1
Recruited
50+

Maude Laberge

Collaborator

Trials
1
Recruited
50+

Findings from Research

A study of 229 general practices found that high-quality primary care, including better access to preferred doctors and effective management of cholesterol levels, is linked to lower rates of premature coronary heart disease (CHD) mortality.
Improving the quality of CHD care from 83% to 86% could potentially reduce premature CHD mortality by 3.6%, highlighting the importance of quality improvement in primary care settings.
Modelling factors in primary care quality improvement: a cross-sectional study of premature CHD mortality.Honeyford, K., Baker, R., Bankart, MJ., et al.[2021]
The implementation of a continuous quality improvement (CQI) intervention in a primary care clinic led to a significant reduction in mean HbA1c levels from 8.9% to 7.9% over 18 months, indicating improved glycemic control for patients with diabetes.
Patients at the CQI intervention clinic had a higher proportion of individuals achieving HbA1c levels of 8% or less (51%) compared to a similar clinic without the intervention (40%), demonstrating the effectiveness of CQI in enhancing diabetes management without increasing healthcare utilization or costs.
Continuous quality improvement can improve glycemic control for HMO patients with diabetes.O'Connor, PJ., Rush, WA., Peterson, J., et al.[2022]
The quality improvement (QI) intervention was successfully implemented in 12 primary care clinics, leading to increased staff participation in QI activities and better use of patient registries, which are important for managing diabetes care.
Despite these improvements in process, the intervention did not result in significant changes in clinical outcomes such as A1C, LDL, or blood pressure levels, indicating that future QI efforts should focus more on specific clinical actions like medication adjustments and engaging patients more actively.
Randomized trial of quality improvement intervention to improve diabetes care in primary care settings.O'Connor, PJ., Desai, J., Solberg, LI., et al.[2019]

References

Modelling factors in primary care quality improvement: a cross-sectional study of premature CHD mortality. [2021]
Continuous quality improvement can improve glycemic control for HMO patients with diabetes. [2022]
Randomized trial of quality improvement intervention to improve diabetes care in primary care settings. [2019]
The impact of a programme to improve quality of care for people with type 2 diabetes on hard to reach groups: The GEDAPS study. [2022]
Practice-level quality improvement interventions in primary care: a review of systematic reviews. [2022]
Recording of adverse events in English general practice: analysis of data from electronic patient records. [2019]
Variations in achievement of evidence-based, high-impact quality indicators in general practice: An observational study. [2022]
The effects of a team-based continuous quality improvement intervention on the management of primary care: a randomised controlled trial. [2018]
Continuous quality improvement in small general medical practices: the attitudes of general practitioners and other practice staff. [2019]
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