Although there is no single playbook that works for all types of practices, some combinations of practice characteristics and operational changes can help practices address cardiovascular disease.
Utilizing operational changes and local context can help primary care providers make meaningful gains in cardiovascular disease care, according to a recent press release from the American Academy of Family Physicians.
Health care providers should adopt a set of care improvements that are tailored to their practice in order to address high blood pressure and smoking, both of which are among the biggest risk factors associated with cardiovascular disease. Health providers can then help patients manage their high blood pressure and can provide smoking cessation interventions.
Investigators found that there is no single playbook that works for all types of practices, but there are combinations of characteristics, amounts of practice facilitation, and operational changes linked with improved cardiovascular disease care. Smaller, solo, and clinician-owned practices that changed routine aspects of their process, such as training assistants to perform accurate blood pressure readings, were able to make substantial improvements.
Other process changes included allowing staff to take repeated blood pressure measures and note second readings in electronic medical records, or equipping clinicians with the tools to perform smoking screening and cessation referrals.
Furthermore, working with a practice facilitator helped practices address cardiovascular disease among their patients. Smaller practices that participated in a moderate amount of facilitation were able to make some improvements, but more facilitation was necessary in larger hospital or health system-owned practices and federally qualified health centers. Based on this, the researchers concluded that “making operational changes alone—in certain clinical settings—was insufficient to achieve meaningful improvements.”
The investigators added that external facilitation along with prioritization of operational changes may be critical to successful quality improvement in practices that are part of larger, more complex systems.
In a corresponding editorial written by Robert L. Phillips, Jr, MD, MSPH, of the American Board of Family Medicine, Phillips identified a common thread throughout the May-June 2021 issue of Annals of Family Medicine. He noted that practice facilitation is key to improving primary care at a systems level and added that researchers have been investigating ways to facilitate behavior change, understand the importance of culture, and respect complexity.
Improving smoking cessation counseling and blood pressure quality metrics in primary care [news release]. EurekAlert; May 11, 2021. https://www.eurekalert.org/pub_releases/2021-05/aaof-isc051121.php. Accessed May 19, 2021.