Welcome to EQUIP-4-PCPs, a program to facilitate quality improvement in primary care practices and promote quality improvement research. EQUIP-4-PCPs is sponsored by the University of Kentucky Department of Family and Community Medicine, the Kentucky Ambulatory Network (KAN), the Kentucky Academy of Family Physicians, and the UK Center for Clinical and Translational Sciences (UK-CCTS) Office of Research Engagement for Advancing Community Health (REACH) with grant support from Health Resources and Services Administration (HRSA).
EQUIP-4-PCPs stands for:
Enabling Quality Improvement in Practice for Primary Care Physicians
This is a program dedicated to helping small private practices achieve their goals for quality improvement and the efficient capture of quality-based reimbursements, and to the advancement of knowledge about quality in primary care.
Most physicians today feel the burden of competing demands as they strive to provide quality healthcare for all of their patients while remaining financially solvent. Pay-for-performance initiatives are beginning to incentivize attention to quality indicators and continuous quality improvement (CQI) activities, but most primary care practices have insufficient support CQI, or for the capture and reporting of data necessary for higher compensation.
EQUIP-4-PCPs aims to:
- help experienced clinicians apply proven methods for setting their own quality-related objectives and making desired changes happen in their practices
- help experienced clinicians streamline routines in their practices with the goal of improving preventive services and/or the management of chronic disease
- facilitate reporting of quality indicators for optimal reimbursement
- facilitate research to identify and disseminate successful quality improvement strategies for primary care practice
Glossary of terms:
Project Facilitators: staff employed or contracted through UK, who are trained and experienced in QI methods for ambulatory medical practice. A Project Facilitator will develop a relationship with each participating practice. S/he will provide direct support to the practice-staff QI Coordinator. The Project Facilitator will make multiple visits during the project period.
Physician Champion: one physician from each participating practice who agrees to support QI efforts in his or her practice, including related documentation. The Physician Champion will meet at the practice site or via phone at least twice with a project faculty member to discuss objectives and program-related resources for that practice. This will include a discussion of key aspects of physician leadership associated with success in practice-based QI. The Physician Champion will choose a practice staff member to be the QI Manager. The Physician Champion will be responsible for final designation of the QI objectives that the practice will pursue.
QI Coordinator: one staff member from each practice, chosen by the Physician Champion, who will coordinate and sustain specific tailored QI efforts and the related performance documentation. An EQUIP Project Facilitator will work closely with the practice QI Coordinator, and be available via email and telephone. Each practice's QI Coordinator will receive training through the project. This may include completion of a web-based QI training module (paid for by the project). This module can be completed in small increments; it can be entered and exited at will. Similar web-based training will be optional for Physician Champions.
Self-Audit: standardized self-audit done by physicians on at least 10 of their own patient charts, focused on performance measures, using materials provided by the project.
EQUIP-4-PCPs Pilot Project
(completed Winter 2006)
The Kentucky Ambulatory Network (KAN) and the Kentucky Academy of Family Physicians (KAFP) launched the first pilot project under the EQUIP-4-PCPs program in 2006 to help physicians efficiently improve measurable quality in their practices. The focus of the pilot project was the management of type 2 diabetes and related clinical documentation. This pilot project was administered through the UK Department of Family and Community Medicine with support from the Kentucky Academy of Family Physicians.
Eight independent private practices, interested in working with us for about 6 months, tested the EQUIP-4-PCPs program and made suggestions for its improvement. Each practice set its own specific objectives related to improving diabetes management (and/or its documentation).
Expectations of the EQUIP-4-PCPs pilot project staff and faculty:
- Provide expertise in QI principles pertinent to office-based primary care
- Provide a Project Facilitator to work with each participating practice over the 6-month period
- Provide training for a practice staff member in basic principles of QI, including how to foster change, report quality indicators, and maintain improvements
- Provide up to 10 hours of free AAFP Prescribed CME credit for QI activities
- Provide all materials and instructions needed for a focused self-audit of diabetes management on 10 patient charts
- Maintain a web-based library of highly-selected tools, guidelines and other materials for use by participating practices
- Audit a larger sample of charts, according to physician's goals, and provide results of audit to physician
Expectations of each participating practice:
- Designate a Physician Champion for this project.
- Designate a QI Coordinator, and provide time for him/her to complete a 4-hour on-line training course
- Interact by telephone and email as needed with project staff and faculty
- Welcome on-site assistance from the EQUIP Project Facilitator
- Set goals and objectives for improving diabetes management (and/or its documentation)
- Support fostering diabetes QI as an important regular duty for the QI Coordinator
- Perform a self-audit of 10 diabetic patient charts
- Facilitate a larger audit of diabetic patient charts by the EQUIP Project Facilitator, and receive the results
- Share ideas for improving efficiency and quality in their practice
- Participate in this project for at least 6 months
- Receive a $400 honorarium from the KAFP Foundation (could be used for staff incentive)
This pilot project was well-accepted by the participants and proceeded smoothly overall. It demonstrated the feasibility of this approach to facilitated QI for chronic care management in small primary care practices, guided “fine-tuning” of the EQUIP model, and laid the groundwork for other projects.