PC-QI implementation strategy | Round 1: prioritization (N = 10) | Round 2: discussion (N = 11) | Round 3: prioritization (N = 10) | |||
---|---|---|---|---|---|---|
Rank | Median (IQR) | Rank (frequency in Top 5) | Median (IQR) | Stakeholder group priority | ||
Needs assessment | 2 | 2 (1.25–3.75) | There is a need for general engagement and assessment of primary care stakeholders for buy-in and ensuring everyone is on the same page in terms of what is meant by PCC (although it was recognized that the PC-QIs are intended to help define) | 3 (6) | 2 (2–2) | 2 Patient; 1 Physician; 3 PCN |
Develop partnerships | 1 | 2 (1–4.75) | There isn’t a need to create new partnerships | 1 (8) | 1 (1–2) | 3 Patient; 2 Physician; 1 PCN; 2 QI Staff |
Obtaining quality improvement resources | 3 | 4.5 (3.25–5) | (Not discussed) | 2 (7) | 3 (3–4.5) | 2 Patient; 2 Physician; 2 PCN; 1 QI Staff |
Aligning measurement efforts | 4 | 5.5 (4.25–7.5) | Greater alignment will come from engagement of both providers and patients | 4 (6) | 3.5 (3–4) | 2 Physician; 3 PCN; 1 QI Staff |
Support from partners for implementation | 6 | 6 (5–7) | (Not discussed) | 10 (1) | 4 (4–4) | 1 Physician |
Champions | 5 | 6 (3–6.75) | Champions are needed to spearhead implementation efforts, but require the data to demonstrate effectiveness | 5 (6) | 4.5 (2.5–5) | 2 Patient; 1 Physician; 2 PCN; 1 QI Staff |
Adapting patient surveys | 9 | 7.5 (7–8.75) | (Not discussed) | N/A (0) | N/A | N/A |
Patient engagement | 7 | 7 (3.25–8.75) | Surprise about patient engagement being ranked so low, although patient engagement was seen to fit under “develop partnerships” | 7 (4) | 2.5 (2–3) | 2 Patient; 1 PCN; 1 QI Staff |
Patient engagement was seen as being critical and needed from the start as part of a co-design process for implementation and to begin changing the norms of providers | ||||||
Some distinction was also made around the need for clinic level engagement and wider engagement as it relates to patient expectations around their care | ||||||
Co-designing materials to implement the PC-QIs | 10 | 8.5 (5.5–9.75) | Surprise around the low ranking of “developing PC-QI materials” | 8 (3) | 3 (2–4) | 1 Patient; 1 Physician; 1 PCN |
Tensions between having standards around tools, but also having some flexibility to tailor based on clinics’ needs | ||||||
Suggested co-designing materials with stakeholders to optimize design of materials | ||||||
Education for clinical staff | 8 | 7.5 (4.75–8.75) | (Discussion partly captured under Needs Assessment) | 6 (5) | 5 (3–5) | 2 Patient; 1 PCN; 2 QI Staff |
**Pilot the Implementation | N/A | N/A | Piloting the implementation where it can be demonstrated that the data can be collected, fed back, and changes made would support implementation. Adjustments to implementation can be made (e.g. after 3, 6, 9 months) based on learning from the pilot | 9 (2) | 4 (4–4) | 1 Patient; 1 PCN |