Engaging primary care practitioners in quality improvement: making explicit the program theory of an interprofessional education intervention
1 School of Rehabilitation, Faculty of Medicine, Université de Montréal, 7077 Park Avenue, Montreal, Quebec H3N 1X7, Canada
2 Agence de la santé et des services sociaux de la Montérégie, 1255 Beauregard St, Longueuil, Quebec J4K 2M3, Canada
3 Centre de santé Sutton, 33 Principale St South, Sutton, Quebec J0E 2K0, Canada
4 Direction générale des services de santé et médecine universitaire, Ministère de la Santé et des Services sociaux, Gouvernement du Québec, Longueuil, Quebec, Canada
5 Département régional de médecine général, 1255 Beauregard St, Longueuil, Quebec J4K 2M3, Canada
6 Fédération des médecins omnipraticiens du Québec, 1440 Sainte-Catherine St West, Suite 1000, Montreal, Quebec H3G 1R8, Canada
7 Centre for Practice-Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital General Campus, 501 Smyth Road, Box 711, Ottawa, Ontario K1H 8L6, Canada
BMC Health Services Research 2013, 13:106 doi:10.1186/1472-6963-13-106Published: 20 March 2013
The scientific literature continues to advocate interprofessional collaboration (IPC) as a key component of primary care. It is recommended that primary care groups be created and configured to meet the healthcare needs of the patient population, as defined by patient demographics and other data analyses related to the health of the population being served. It is further recommended that the improvement of primary care services be supported by the delivery of feedback and performance measurements. This paper describes the theory underlying an interprofessional educational intervention developed in Quebec’s Montérégie region (Canada) for the purpose of improving chronic disease management in primary care. The objectives of this study were to explain explicitly the theory underlying this intervention, to describe its components in detail and to assess the intervention’s feasibility and acceptability.
A program impact theory-driven evaluation approach was used. Multiple sources of information were examined to make explicit the theory underlying the education intervention: 1) a literature review and a review of documents describing the program’s development; 2) regular attendance at the project’s committee meetings; 3) direct observation of the workshops; 4) interviews of workshop participants; and 5) focus groups with workshop facilitators. Qualitative data collected were analysed using thematic analysis.
The theoretical basis of the interprofessional education intervention was found to be work motivation theory and reflective learning. Five themes describing the workshop objectives emerged from the qualitative analysis of the interviews conducted with the workshop participants. These five themes were the importance of: 1) adopting a regional perspective, 2) reflecting, 3) recognizing gaps between practice and guidelines, 4) collaborating, and 5) identifying possible practice improvements. The team experienced few challenges implementing the intervention. However, the workshop’s acceptability was found to be very good.
Our observation of the workshop sessions and the interviews conducted with the participants confirmed that the objectives of the education intervention indeed targeted the improvement of interprofessional collaboration and quality of care. However, it is clear that a three-hour workshop alone cannot lead to major changes in practice. Long-term interventions are needed to support this complex change process.