title: Combining administrative data feedback, reflection and action planning to engage primary care professionals in quality improvement: qualitative assessment of short term program outcomes.
abstract: BACKGROUND
  Improving primary care for chronic disease management requires a coherent, integrated approach to quality improvement. Evidence in the continuing professional development (CPD) field suggests the importance of using strategies such as feedback delivery, reflective practice and action planning to facilitate recognition of gaps and service improvement needs. Our study explored the outcomes of a CPD intervention, named the COMPAS Project, which consists of a three-hour workshop composed of three main activities: feedback, critical reflection and action planning. The feedback intervention is delivered face-to-face and presents performance indicators extracted from clinical-administrative databases. This aim of this study was to assess the short term outcomes of this intervention to engage primary care professional in continuous quality improvement (QI).
  
  
  METHODS
  In order to develop an understanding of our intervention and of its short term outcomes, a program evaluation approach was used. Ten COMPAS workshops on diabetes management were directly observed and qualitative data was collected to assess the intervention short term outcomes. Data from both sources were combined to describe the characteristics of action plans developed by professionals. Two independent coders analysed the content of these plans to assess if they promoted engagement in QI and interprofessional collaboration.
  
  
  RESULTS
  During the ten workshops held, 26 interprofessional work teams were formed. Twenty-two of them developed a QI project they could implement themselves and that targeted aspects of their own practice they perceived in need of change. Most frequently prioritized strategies for change were improvement of systematic clientele follow-up, medication compliance, care pathway and support to improve adoption of healthier life habits. Twenty-one out of 22 action plans were found to target some level of improvement of interprofessional collaboration in primary care.
  
  
  CONCLUSIONS
  Our study results demonstrate that the COMPAS intervention enabled professionals to target priorities for practice improvements and to develop action plans that promote interprofessional collaboration. The COMPAS intervention aims to increase capability for continuous QI, readiness to implement process of care changes and team shared goals but available resources, climate and culture for change and leadership, are also important required conditions to successfully implement these practice changes.
  
  
  CONCLUSIONS
  We think that the proposed approach can be very useful to support and engage primary care professionals in the planning stage of quality improvement projects since it combines key successful ingredients: feedback, reflection and planning of action.
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.affiliation: Agence de la santé et des services sociaux de la Montérégie, 1255 Beauregard Street, Longueuil, Quebec, J4K 2M3, Canada. desorcyb@icloud.com.
authors.forename: Bruno
authors.initials: B
authors.lastname: Désorcy
authors.affiliation: Faculty of medicine, Université de Sherbrooke, Pavillon Gérald-La Salle, 3001, 12e avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada. isabelle.gaboury@usherbrooke.ca.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gaboury
authors.affiliation: Centre de santé Sutton, 33 Principale St South, Sutton, Quebec, J0E 2K0, Canada. michel.camirand.cssslp16@ssss.gouv.qc.ca.
authors.forename: Michel
authors.initials: M
authors.lastname: Camirand
authors.affiliation: Agence de la santé et des services sociaux de la Montérégie, 1255 Beauregard Street, Longueuil, Quebec, J4K 2M3, Canada. jean.rodrigue.agence16@ssss.gouv.qc.ca.
authors.forename: Jean
authors.initials: J
authors.lastname: Rodrigue
authors.affiliation: Collège des médecins du Québec, 2170, boulevard René-Lévesque Ouest, Montreal, Quebec, H3H 2T8, Canada. lquesnel@cmq.org.
authors.forename: Louise
authors.initials: L
authors.lastname: Quesnel
authors.affiliation: Fédération des médecins omnipraticiens du Québec, 3500 boul. de Maisonneuve Ouest, bureau 2000, Westmount, Quebec, H3Z 3C1, Canada. cguimond@fmoq.org.
authors.forename: Claude
authors.initials: C
authors.lastname: Guimond
authors.affiliation: Fédération des médecins omnipraticiens du Québec, 3500 boul. de Maisonneuve Ouest, bureau 2000, Westmount, Quebec, H3Z 3C1, Canada. mlabelle@fmoq.org.
authors.forename: Martin
authors.initials: M
authors.lastname: Labelle
authors.affiliation: Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331, rue Hochelaga, Montreal, Quebec, H1N 3V2, Canada. aithuyhuynh@gmail.com.
authors.forename: Ai-Thuy
authors.initials: AT
authors.lastname: Huynh
authors.affiliation: Centre for Practice-Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, 501 Smyth Road, Box 711, Ottawa, Ontario, K1H 8L6, Canada. jgrimshaw@ohri.ca.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Grimshaw
mesh_terms: D002908:Chronic Disease; D003299:Cooperative Behavior; D005246:Feedback; D006282:Health Personnel; D006801:Humans; D007857:Leadership; D010347:Patient Care Planning; D010934:Planning Techniques; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration*