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Quality improvement
A tailored, multifaceted programme in capitation-based family practices improved appropriate use of preventive care manoeuvres

https://doi.org/10.1136/ebm.6.6.191

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    (2001) CMAJ 164, 757. Lemelin J, Hogg W, Baskerville N.. Evidence to action: a tailored multifaceted approach to changing family physician practice patterns and improving preventive care.. Mar 20;. :. –63.
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 QUESTION: Can a multifaceted intervention programme using nurse facilitators improve preventive care (increased rates of recommended preventive care manoeuvres and decreased rates of non-recommended manoeuvres) in capitation-based family medicine practices?

    Design

    Randomised {allocation concealed*}†, unblinded,* controlled trial with 18 months of follow up.

    Setting

    46 capitation-based health services organisations (HSOs) in family practice settings in Ontario, Canada.

    Practices

    46 HSOs were allocated, and 45 were analysed (64% group practices, 53% university affiliated, mean of 3 physicians per practice, and mean age of patients 47 y).

    Intervention

    23 HSOs were allocated to each intervention. Intervention HSOs were assigned to 1 of 3 nurse facilitators. The nurse made several visits and worked with the practice physicians and staff as a facilitator to adopt a 7-component programme to each practice's needs and wishes. The intervention strategies were designed …

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