title: Physician perspectives on a tailored multifaceted primary care practice facilitation intervention for improvement of cardiovascular care.
abstract: BACKGROUND
  Practice facilitation is an effective way to help physicians implement change in their clinics, but little is known about physicians' perspectives on this service.
  
  
  OBJECTIVE
  To examine physicians' responses to a practice facilitation program, focussing on their overall satisfaction, perceived most significant clinical changes, and interactions with the facilitator.
  
  
  METHODS
  The Improved Delivery of Cardiovascular Care program investigated the impact of practice facilitation on improving the quality of cardiovascular primary care in Eastern Ontario, Canada, from 2007 to 2011. We conducted a qualitative content analysis of post-intervention surveys completed by participating physicians, using a constant comparison approach framed around the Chronic Care Model.
  
  
  RESULTS
  Ninety-five physicians completed the survey. Physicians overwhelmingly viewed the program positively, though descriptions of its benefits and impact varied widely. Facilitators filled three key roles for physicians, acting as a resource centre, motivator and outside perspective. Physicians adopted a number of changes in their practices. These changes include adoption of clinical information systems (diabetes registries), decision support tools (chart audits, guideline documents, flow sheets) and delivery system design (community resources).
  
  
  CONCLUSIONS
  Most physicians appreciated having access to a practice facilitator and viewed the intervention positively. Insight into physicians' perspectives on practice facilitation provides a valuable counterpoint to outcomes-based evaluations of such services. Further research should investigate potential obstacles in the group of physicians who make fewer practice changes, as well as the sustainability of this type of facilitation intervention.
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute and Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada. cliddy@bruyere.org.
authors.forename: Clare
authors.initials: C
authors.lastname: Liddy
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute and Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jatinderpreet
authors.initials: J
authors.lastname: Singh
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute and.
authors.forename: Merry
authors.initials: M
authors.lastname: Guo
authors.affiliation: C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute and Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Hogg
mesh_terms: D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D058007:Physicians, Primary Care; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration*; D011795:Surveys and Questionnaires
keywords: Primary care; practice facilitation; qualitative study.