Emerging Methodologies for Systems Improvement in Primary Care
Developed at the University of Oklahoma, UNYNET is testing the efficacy of Practice Enhancement Assistants or PEAS in improving quality in Primary Care Offices. The strength of PEAS is that the help to overcome the burden of competing demands while at the same time have the ability to share best practices rapidly between offices. We have two AHRQ grants, one regarding geriatric drug safety and the other regarding chronic kidney disease that will test the usefulness of PEAS in underserved office settings compared to usual care and on-site physician education.Practice Enhancement Assistants
Practice Enhancement Assistants
Practice enhancement assistants (PEAs) are individuals who develop a relationship with a group of practices over a period of time, generally eight practices per PEA, in order to help them to evaluate and improve their quality of care. This is generally accomplished through practice audits and feedback, patient satisfaction surveys, staff training, “cross-fertilization” (sharing of ideas among the eight practices), coordination of quality improvement initiatives, and provision of specific materials and resources (flow sheets, computer training, etc.). The idea for the PEA concept came from England, where “practice facilitators” have been a feature of the national health program for some time, and from Canada, where similar outreach workers have been an important part of a successful initiative to increase rates of delivery of preventive services by primary care physicians in Ontario.
It has been our experience that physicians who are involved in research
projects from design to results tend to have less trouble integrating
the findings into their practices. The obstacles that we have
encountered are often technical (e.g. How, exactly do you do that? or
Where can I get one of those?) or they have to do with the large differences
that exist between practices (e.g., “I see how it works, but I’m
not sure how to make it fit in our system.”). Based upon
the experience of several investigators in the United States and England,
we have concluded that facilitators who go into the practices to help
physicians and their staff implement new methods may be an effective
way to overcome most of these obstacles (Modell et al, 1998; Bryce et
al, 1995; Carroll et al, 1994; Carney et al, 1992).
Roles and functions of Practice Enhancement Assistants
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