- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT03054090
Heart of Virginia Healthcare (HVH)
Restoring Primary Care in Virginia: PCOR Learning as a Pathway to Value
연구 개요
상세 설명
Restoring Primary Care in Virginia: Patient Centered Outcomes Research (PCOR) Learning as a Pathway to Value is an extension of the Virginia Center for Health Innovation's (VCHI) work to address primary care transformation in its Virginia Health Innovation Plan. VCHI, in partnership with four of Virginia's schools of medicine, the Virginia Center for Health Quality (VHQC), and evaluation specialists at George Mason University, will form the Virginia Primary Care Transformation Collaborative (VPCTC). They will use an evidence-based, comprehensive strategy to help up to 300 small-to-medium sized primary care practices: 1) accelerate incorporation of PCOR clinical and organizational findings into practice with an initial focus on cardiovascular health and the Aspirin, Blood Pressure, Cholesterol, and Smoking (ABCS); 2) increase their capacity to integrate new PCOR findings on an on-going basis; and 3) learn strategies that can help them sustain and revitalize their organizations while restoring the joy to primary care practice. Practice supports will include on-site coaching, expert consultation, collaborative learning events, an online support center, and data feedback and benchmarking. As a result of this project, "Restoring Primary Care in Virginia," participating practices will develop stronger Quality Improvement (QI) capacity and learn strategies that can help them sustain and revitalize their organizations while restoring the joy to primary care practice. The value proposition to recruit and retain participating practices includes: Improved financial performance; improved clinician, staff, and patient satisfaction; objectively improved quality of care; improved ability to negotiate for and receive pay for performance bonuses, including Electronic Medical Record (EMR) meaningful use stage 2; completion of Part IV certification by the American Board of Family Medicine (ABFM) and American Board of Internal Medicine (ABIM) for QI work completed in this initiative; and engagement in a self-sustaining learning collaborative of similar practices after the end of the project. The evaluation plan is designed to answer these questions: (1) Did the VPCTC intervention improve the performance of small physician practices in Virginia as measured by the individual ABCS? (2) Which elements of the intervention were most important to the physicians for performance improvement? (3) Did "maintenance" or follow-up intervention activities add value or was the initial intense intervention enough to produce the measured impact? (4) Which internal contextual or structural features of practices at baseline are most likely to be associated with improved performance (e.g., expansive use of EMRs, degree of adaptive reserve or change processing capacity, number of physicians in the practice, etc.)? (5) Did the VPCTC improve the capacity of small physician practices to implement future PCOR findings and improve quality on an ongoing basis? (6) Which elements of the intervention were most important to the physicians for QI capacity building? Multivariate statistical modeling of clinical performance and survey data will be performed to answer questions 1, 3, and 4.
Qualitative interviews, surveys and statistical analysis of survey results will answer questions 2, 5, and 6.
연구 유형
등록 (실제)
단계
- 해당 없음
참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- small to medium sized primary care practices in virginia that serve adults
Exclusion Criteria:
- large sized primary care practices
- pediatric practices
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 건강 서비스 연구
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
---|---|
다른: Quality Improvement support
A blended support strategy will include practice facilitation, expert consultation, collaborative learning events, an online support center, and data feedback and benchmarking.
|
Practices will receive a blended strategy of quality improvement facilitation to help participating practices incorporate PCOR clinical and organizational findings while building their overall practice capabilities.
Primary care practices will be provided tools and training to improve the rates of screening and treatment of risk factors for heart attacks and strokes, as well as other chronic illnesses and the delivery of preventive services.
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Aspirin prescriptions
기간: 3 month
|
Practice level rates of aspirin or other anti-thrombotics being prescribed.
The outcome measure will be assessed from data extracted from practice EMR.
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3 month
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Blood pressure
기간: 3 months
|
Blood pressure control for hypertensives.
The outcome measure will be assessed from data extracted from practice EMR.
|
3 months
|
Statin prescriptions
기간: 3 months
|
Practice level rates of Statins being prescribed for categories of higher risk cholesterol levels.
The outcome measure will be assessed from data extracted from practice EMR.
|
3 months
|
Smoking
기간: 3 months
|
Smoking assessment.
The outcome measure will be assessed from data extracted from practice EMR.
|
3 months
|
Smoking
기간: 3 months
|
Smoking cessation counseling.
The outcome measure will be assessed from data extracted from practice EMR.
|
3 months
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Capacities to incorporate new patient centered outcome research
기간: 1 year after intervention
|
Capacities of practices to incorporate new patient centered outcome research into their care of patients.
This outcome measure will be assessed using surveys.
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1 year after intervention
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Capacities to incorporate new patient centered outcome research
기간: 1 year after intervention
|
Capacities of practices to incorporate new patient centered outcome research into their care of patients.
This outcome measure will be assessed using interviews.
|
1 year after intervention
|
Joy in practice
기간: 1 year after intervention
|
This outcome measure will be assessed by way of surveys.
|
1 year after intervention
|
공동 작업자 및 조사자
협력자
수사관
- 수석 연구원: Anton Kuzel, MD, Virginia Commonwealth University
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
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