Quality improvement in small office settings: an examination of successful practices.

Authors

Daniel Wolfson, American Board of Internal Medicine Foundation, Philadelphia, PAFollow
Elizabeth Bernabeo, Quality Research, American Board of Internal Medicine, Philadelphia, PAFollow
Brian Leas, Department of Health Policy, Thomas Jefferson University, Philadelphia, PAFollow
Shoshanna Sofaer, School of Public Affairs, Baruch College, New York, NY
Gregory Pawlson, National Committee for Quality Assurance, Washington, DC,Follow
Donna Pillittere, National Committee for Quality Assurance, Washington, DC,Follow

Document Type

Article

Publication Date

1-1-2009

Comments

This article has been peer reviewed. It was published in BMC Family Practice Volume 10, Issue 14, February 9, 2009, Pages 1-12. The published version is available at DOI: 10.1186/1471-2296-10-14. Copyright © BioMed Central Ltd.

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.

Recommended Citation

Wolfson, Daniel; Bernabeo, Elizabeth; Leas, Brian; Sofaer, Shoshanna; Pawlson, Gregory; and Pillittere, Donna, "Quality improvement in small office settings: an examination of successful practices." (2009). College of Population Health Faculty Papers. Paper 43.
https://jdc.jefferson.edu/healthpolicyfaculty/43