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Table 4 Summary of consensus results for strategy prioritization, by round

From: Co-designing person-centred quality indicator implementation for primary care in Alberta: a consensus study

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

  1. Panelists asked to rank all ten strategies in round 1; prioritization in top five not used to determine ranking
  2. **indicates a new strategy that was developed from Round 2 (not ranked in round 1). PC-QIs refer to Person-Centred Quality Indicators; PCC refers to person-centred care; QI refers to quality improvement; PCN refers to Primary Care Network; IQR refers to the interquartile range