Managing Your Practice

AHRQ Practice Toolbox: Practice facilitation


This is the eighth in a series of articles from the National Center for Excellence in Primary Care Research (NCEPCR) in the Agency for Healthcare Research and Quality (AHRQ). This series introduces sets of tools and resources designed to help your practice.

Last month’s article discussed AHRQ’s tool and resources for practice transformation, or how to help make your practice ready for advances such as shared decision making, team-based care, and integrating behavioral health and primary care. True practice transformation requires a commitment to a culture of ongoing quality improvement. Use of practice facilitation, an evidence-based approach to quality improvement, can be a key element to helping primary care practices make the necessary changes for transformation. Practice facilitators (also known as practice coaches, quality improvement coaches, or practice enhancement assistants) are specially trained individuals who assist primary care clinicians in research and quality improvement projects. They are distinguished from consultants through specialized training, broad scope of practice, and long-term relationships with an organization, its staff and clinicians, and its patients.

If you are wondering how a practice facilitator can help you, AHRQ offers How a Practice Facilitator Can Support Your Practice. This tip sheet provides ideas and techniques for primary care practices interested in getting started with quality improvement activities and describes the benefits of working with a practice facilitator. The tip sheet is distilled from a more extensive white paper on Engaging Primary Care Practices in Quality Improvement: Strategies for Practice Facilitators, which presents a framework for engaging primary care practices in quality improvement and provides strategies for sustained involvement in the undertaking.

For those with greater interest in implementation of practice facilitation, AHRQ offers the Practice Facilitation Handbook: Training Modules for New Facilitators and Their Trainers. The Handbook is designed to assist in the training of new practice facilitators as they begin to develop the knowledge and skills needed to support meaningful improvement in primary care practices. AHRQ built upon the modules in the Handbook with the Primary Care Practice Facilitation Curriculum. The Curriculum updates the modules in the Handbook and adds an additional twelve modules for a total of 32 modules. More importantly, some of the modules can be used by clinicians and staff as a sort of Quality Improvement 101. Modules on appreciative inquiry, approaches to quality improvement, redesigning work flow, root cause analysis, and measuring clinical performance can be useful to anyone interested in increasing their knowledge and skills for quality improvement.

Dr. Theodore G. Ganiats, director of the National Center for Excellence in Primary Care Research at AHRQ

Dr. Theodore G. Ganiats

Clinicians or organizations interested in starting a practice facilitation program or other integrated quality improvement program should review AHRQ’s Developing and Running a Practice Facilitation Program: A How-To Guide. The Guide focuses on designing and administering facilitation programs, not the content of an actual facilitation intervention. It is designed for use by directors of facilitation programs, not the facilitators themselves. Its goal is to make the knowledge and experience of experts available as a resource for those who want to design and administer their own facilitation program. This manual can also be a resource for directors of existing programs who want to enhance their program and intervention models.

Mr. McNellis is senior adviser for primary care at AHRQ and Dr. Ganiats is director of the National Center for Excellence in Primary Care Research at AHRQ.

Links from the AHRQ Web site:

How a Practice Facilitator Can Support Your Practice

Engaging Primary Care Practices in Quality Improvement: Strategies for Practice Facilitators

Primary Care Practice Facilitation Curriculum

Practice Facilitation Handbook

A How-To Guide on Developing and Running a Practice Facilitation Program

These and other tools can be found at the NCEPCR Web site.

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