Practice facilitation is a highly customized, staged approach to helping a practice to implement process and structural changes to enhance the quality of care and improve patient and staff satisfaction. Facilitators are certified to have 4 core competencies:
- Interpersonal skills to build support for and facilitate change
- Methods for accessing and using data to drive change
- Quality improvement and change management strategies
- Health information technology optimization.
What are Practice Facilitators?
Practice facilitators are best described as “change agents” who can engage with health care practice members to help understand the steps needed to implement changes in work flows and other processes to help run more efficient and relevant health care facilities - while improving outcomes for patients and staff members.
More simply stated, practice facilitators help practices understand HOW to make improvements, thus in addition to making sense of the “why” changes are needed, provide critical support in guiding practice in “how” to take action and make sure that actions are linked to improvements.
The idea is to build change and quality improvement capacity within practice staff who can then lead such efforts long after the practice facilitators have moved on to help other practices. Going forward, practices can then apply their improvement skills to new challenges or conditions that need attention.
Who are our Practice Facilitators?
In the South Eastern Collaboration to Enhance Blood Pressure Control project (SEC), we are partnered with the North Carolina Area Health Education Center’s practice support program who has been leading practice support efforts in North Carolina for years (https://www.ncahec.net/core_service/practice-support/). NC AHEC has provided the foundation of how we implement change and evaluate the SEC practice facilitation intervention. One of the many exciting aspects of the SEC work is that practice facilitators from the Alabama AHEC are involved and are mentored by NC AHEC facilitators. So AL based facilitators now serve as change agents for Alabama primary care practices (AL AHEC links https://www.seaahec.org/, http://www.wcaahec.org/)
Key Driver Implementation Scale (KDIS)
In the SEC study, we use the Key Driver Implementation Scale (KDIS) to understand a practices progress with implementing domains of activities that are rooted in the chronic care model.
These domains include:
- Optimal use of clinical information systems
- i.e. pulling and reviewing hypertension control rates over time to see if changes result in improvements in HTN control rates
- Standardizing care processes
- such as following evidenced based guidelines treating hypertension and measuring BP accurately
- Engaging patients in self-management support
- For instance using home blood pressure monitoring and BP logs sharing this data with care providers.
Optimization of how care teams work together to provide high quality care
(Margolis 2010, DeWalt 2013)