A How-To Guide
Table of Contents
Using This Guide
Purpose and Focus
Terminology and Naming Conventions
Overview of Chapters
1. Background and Introduction
Supporting Primary Care Improvement
Primary Care Extension Programs and EvidenceNOW
The Value of Multiorganizational Extension Programs To Support Primary Care QI
2. Developing and Running a State-Based Extension Program To Support QI in Primary Care
Conduct Landscape Review and Needs Assessment
Understand Your State’s QI Experience and Existing Capacity
Understand the Needs and Interests of Primary Care Practices
Develop a Mission Statement
Invite Partners to Participate
Identify Needed Expertise
Engage Partners
Develop an Organizational and Governance Structure
Organizing Framework
Lead Organization
Leadership and Governance Structure
Working Groups
Staffing
Form the Extension Program
Meetings and Other Activities
Develop a Project Charter and Bylaws
Assess Partner Engagement
3. Building and Maintaining a Network of Primary Care Practices
Plan a Statewide Network of Practices
Recruit Practices
Align With Practice Priorities
Develop a Value Proposition
Provide Incentives
Build on Existing Relationships
Design Effective Outreach Strategies
Additional Recruitment Strategies for Recruiting Practices for a QI Project
Engage and Retain Practice Participation
Onboard Practices
Maintain Practice Engagement
4. Selecting and Delivering Services To Support Quality Improvement
Select and Tailor QI Services
Develop QI Support Services and Mechanisms for Delivery
Support for Practices in a Broad Network
Supportive Services for Practices in a QI Project
Practice Facilitation
Practice Facilitation Approach, Training, and Oversight
5. Moving Toward Sustainability
Plan for Sustainability
Find Sustainable Funding for Your Primary Care Extension Program
Potential Funding Sources
Other Funding Strategies and Tips
Conclusion
References
Exhibits
Table 1. Names of Cooperatives, Practice Networks, and QI Projects, by State
The EvidenceNOW Model
Table 2. The Range of Linkages for Community-Based Initiatives
Table 3. Selected Working Group Names and Functions Across Cooperatives
Table 4. Quality Improvement Support for Practices in a Broad Network
Table 5. QI Supportive Services for Practices in a QI Project
Table 6. Sustainability Domains With Descriptions and Considerations
Table 7. Support for Primary Care Quality Improvement, by Type and Geographic Reach
Abt Global, LLC developed this guide under a contract with the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (Contract No. HHSP233201500013I, Task Order No. 75P00120F37007).
The authors are solely responsible for this document’s contents, findings, and conclusions, which do not necessarily represent the views of AHRQ. Readers should not interpret any statement in this product as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the authors has any affiliation or financial involvement that would pose a conflict of interest in any area of this research.
Acknowledgments: The Abt team included Jessie Gerteis, Ellen Childs, Colette Tano, Daniella Chambers, Nam Ha, Elizabeth Leftwich, Nataly Johanson Tello, Sarah Shoemaker-Hunt, Alyssa Brocker, Molly Vaughan, and Ann Loeffler. We would like to thank the four EvidenceNOW Building State Capacity cooperatives: Alabama Cardiovascular Cooperative, Healthy Hearts for Michigan, Heart Healthy Ohio, and Tennessee Heart Health Network. This guide draws upon content from their grant applications and progress reports, as well as on information they shared directly with the Abt team. We would also like to thank our AHRQ colleagues who provided valuable direction and feedback throughout the development of this guide, including Cindy Brach, Jesse Crosson, Daniel Miller, and Nora Mueller. We would also like to thank Julie Schilz from the Primary Care Development Corporation for her review and insights.
Suggested Citation: Abt Global. Developing and sustaining state-based infrastructure to support primary care quality improvement: A how-to guide. AHRQ Publication No. 24-0073. Rockville, MD: Agency for Healthcare Research and Quality. August 2024.
