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Practice Facilitation

AHRQ’s Primary Care Practice Facilitation (PCPF) learning community provides information and learning opportunities to individuals with an interest in practice facilitation as one way to improve primary care practice.

About Practice Facilitation

A growing body of evidence supports practice facilitation as an effective strategy to improve primary health care processes and outcomes, including the delivery of wellness and preventive services, through the creation of an ongoing, trusting relationship between an external facilitator and a primary care practice.

Practice facilitation is a supportive service provided to a primary care practice by a trained individual or team of individuals. These individuals use a range of organizational development, project management, quality improvement (QI), and practice improvement approaches and methods to build the internal capacity of a practice to help it engage in improvement activities over time and support it in reaching incremental and transformative improvement goals. This support may be provided onsite, virtually (through phone conferences and Webinars), or through a combination of onsite and virtual visits.

What activities do practice facilitation programs support?

Practice facilitation may involve a wide range of activities, depending on the needs and goals of the practice. Taken together, these form a coherent set of activities for practice change and redesign. They include, but aren’t limited to, the following:

  • Assessment of and feedback to practices regarding organizational, clinical, and business functions to drive change
  • Use of practice-level data to drive change
  • Training of staff in QI methods and specific transformation processes, such as team-based care
  • Formation and facilitation of practice QI teams
  • Executive coaching and leadership training
  • Best practices in QI structures and methods
  • Support, encouragement, reinforcement, and recognition of successes
  • Project and change management
  • Resource identification and procurement
  • Capacity building in the use of health IT to support improved clinical care and office efficiency
  • Cross-pollination of good ideas and best practices between primary care practices
  • Capacity building for improved linkages to outside resources
  • Technical assistance in implementing particular models of care, such as the chronic care model (CCM)

In addition to supporting general QI work and these specific activities, practice facilitators also can support activities more directly related to patient centered medical home (PCMH) transformation goals.

White Papers

Curriculum and Training

Find a core curriculum for practice facilitation, a how-to guide for developing a practice facilitation training program, past webinars, case studies of exemplar practice facilitation training programs, and other training opportunities.

Curriculum

AHRQ’s Primary Care Practice Facilitation Curriculum
AHRQ’s Primary Care Practice Facilitation Curriculum is designed to assist in the training of new practice facilitators as they begin to develop the knowledge and skills needed to support meaningful improvement in primary care practices.

Guide

A How-To Guide on Developing and Running a Practice Facilitation Program
(PDF Version — 2.9MB) PDF Help
This how-to guide is for organizations interested in starting a practice facilitation program aimed at improving primary care. The practice facilitation programs described in this guide are designed to work with primary care practices on quality improvement activities, with an emphasis on primary care redesign and transformation. The guide focuses on how to establish and run an effective practice facilitation program, and is intended for organizations or individuals who will develop, design, and administer such programs.

This guide was developed based on information and resources shared by more than 30 experts in the field of practice facilitation. AHRQ convened the expert working group through a series of webinars and conference calls over a nine month period in 2011. These experts provided practical knowledge and hard-won lessons from their experiences in practice facilitation, and shared resources that they developed or found useful.

Topics covered in the guide include:

  1. Background and existing evidence for practice facilitation
  2. Creating the administrative foundation for your practice facilitation program
  3. Funding your practice facilitation program
  4. Developing your practice facilitation approach
  5. Hiring your practice facilitators
  6. Training your practice facilitators
  7. Supervising and supporting your practice facilitators
  8. Evaluating the quality and outcomes of your practice facilitation program

In addition, the guide includes an extensive collection of tools and links to resources relevant to the development, operation and maintenance of your practice facilitation program.

Webinars

Case studies of exemplar practice facilitation training programs

Overview
This brief summary highlights characteristics of three exemplar Primary Care Practice Facilitation (PCPF) training programs that are featured in this section as individual case studies. Case studies include information about the program's background, design, course components, trainees, faculty, process for internal quality improvement, outcomes, and administration. Lessons learned and next steps for the program are described also.

HealthTeamWorks' Coach University
This case study features one of the country's leading medical practice coach training programs that convene groups of trainees for a weeklong educational program, or "boot camp," to teach knowledge and skills for successful practice facilitation. After attending boot camp in Colorado, trainees are provided support throughout the next year as part of the program's collaborative coaching model.

Millard Fillmore College Practice Facilitator Certificate Program
This case study describes an online distance-learning course that teaches core competencies of practice facilitation work, as well as specialized skills facilitators will need when working with a medical practice. The program's online format includes seminars and virtual group discussions to encourage participants to leverage each other’s expertise.

Practice Coach Training for the North Carolina AHEC Practice Support Program
This case study features a training program in North Carolina that prepares practice coaches to serve on regional practice facilitation teams. These teams work with primary care practices to improve quality of care, transform to patient-centered medical homes, implement electronic health records, and attain meaningful use certification.

Other training opportunities

Programs in the Field

Discover case studies and lessons learned from the field of practice facilitation.

Case Studies

Case Studies of Leading Primary Care Practice Facilitation Programs - 02/28/2013
(PDF Version — 2.4MB) PDF Help
This document includes the Overview, all 4 Case Studies, and Lessons Learned

Facilitation in the Context of an Area Health Education Center: The North Carolina AHEC Practice Support Program — 02/04/2013
(PDF Version — 636KB) PDF Help

Facilitation in the Context of a Practice-Based Research Network: Oklahoma's Practice Enhancement Assistants — 02/04/2013
(PDF Version — 1.2MB) PDF Help

Practice Facilitation Activities of the Safety Net Medical Home Initiative — 02/04/2013
(PDF Version — 2.5MB) PDF Help

Vermont Blueprint's EQuIP Program: A Practice Facilitation Program Supporting Statewide Health System Reform — 02/04/2013
(PDF Version — 1.33MB) PDF Help

Lessons Learned from Leading Models of Practice Facilitation — 02/28/2013
(PDF Version — 989KB) PDF Help

Case Studies of Leading Primary Care Practice Facilitation Programs: Overview — 02/04/2013
(PDF Version — 592KB) PDF Help

Quality Improvement

This section includes resources for engaging primary care practices in quality improvement.

White Papers

Engaging Primary Care Practices in Quality Improvement: Strategies for Practice Facilitators
(PDF Version — 1MB) PDF Help
This white paper describes approaches practice facilitators can take to engage primary care practices in ongoing quality improvement (QI) activities. It presents a framework for engaging primary care practices in QI and provides practical strategies for gaining initial buy-in from practices, maintaining meaningful and sustained engagement in QI efforts, and working with multiple QI programs.

Executive Summary

Tip Sheet

Briefs

Building Capacity for Primary Care Quality Improvement
These briefs describe the need for external infrastructure to help primary care practices develop quality improvement (QI) capacity and describe approaches and supports for ongoing QI.

PCPF eNewsletters

The eNewsletters share perspectives on questions and answers submitted by learning community members, as well as resources, research articles, and events of interest.

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