title: Engaging primary care practitioners in quality improvement: making explicit the program theory of an interprofessional education intervention.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Rehabilitation, Faculty of Medicine, Université de Montréal, 7077 Park Avenue, Montreal, Quebec H3N 1X7, Canada. brigitte.vachon@umontreal.ca
authors.forename: Brigitte
authors.initials: B
authors.lastname: Vachon
authors.forename: Bruno
authors.initials: B
authors.lastname: Désorcy
authors.forename: Michel
authors.initials: M
authors.lastname: Camirand
authors.forename: Jean
authors.initials: J
authors.lastname: Rodrigue
authors.forename: Louise
authors.initials: L
authors.lastname: Quesnel
authors.forename: Claude
authors.initials: C
authors.lastname: Guimond
authors.forename: Martin
authors.initials: M
authors.lastname: Labelle
authors.forename: Johanne
authors.initials: J
authors.lastname: Fournier
authors.forename: Jeremy
authors.initials: J
authors.lastname: Grimshaw
mesh_terms: D004496:Education, Continuing; D005240:Feasibility Studies; D006282:Health Personnel / Q000193:education*; D006801:Humans; D033183:Interdisciplinary Communication; D007857:Leadership; D008962:Models, Theoretical; D016134:Organizational Policy; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000592:standards*; D024382:Professional Role; D058996:Quality Improvement / Q000458:organization & administration*; D011792:Quebec