Continuous Quality Improvement Cohorts on Advanced Access

NCT ID: NCT05715151

Last Updated: 2023-02-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-21

Study Completion Date

2025-06-01

Brief Summary

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The goal of this clinical trial is to compare the implementation and effects of CQI cohorts on AA for PHC clinics. The main questions it aims to answer are to assess the effectiveness of CQI cohorts on AA outcomes.

Detailed Description

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SIGNIFICANCE AND PURPOSE: Timely access to primary healthcare is one cornerstone of strong primary healthcare. Across Canada, timely access remains a significant challenge. One of the most highly recommended models around the world to improve timely access is advanced access (AA). Over the last two decades, AA has become increasingly popular in Canada. AA model has been widely promoted by the College of Family Physicians of Canada and several other provincial organizations and professional associations. Some tools to support the implementation of AA to PHC providers and practices have been developed such as workbook by Health Quality Ontario and Doctor of BC. However, those tools are important assets to initiate a reflection to improve, they are often not sufficient. Eight PHC teams interested in improving and expanding the implementation of AA have been coached through several PDSA cycles. However, the personalized support model used is very demanding in terms of capacity and resources. These findings guided the research team in developing and evaluating a Continuous Quality Improvement (CQI) Cohort program on advanced access to support Primary healthcare (PHC) teams.This study aims to develop knowledge on an externally facilitated CQI pan-Canadian cohort program that could potentially be transferred to provincial organizations or professional associations wishing to support clinics in quality improvement projects.

OBJECTIVE: Assess the effectiveness of CQI cohorts on AA outcomes.

QI INTERVENTION PROGRAM: PHC teams will participate in an externally facilitated CQI program focusing on AA. The proposed program consists of cycle of three key activities; 1) Interprofessional reflective sessions and need prioritization, 2) Group mentoring and PDSA Cycles and 3) Cohort cross-learning exchange opportunities.

METHODS: This study will be based on the cluster-controlled trial of a CQI program of PHC teams on AA. 48 PHC teams from Quebec will participate to the externally facilitated CQI cohort intervention. Volunteer clinics from the intervention regions will receive the CQI intervention for 18 months. Intervention clinics will be matched to PHC clinics located in other regions to compose the control group. The match will be based on the clinic level (1 to 10, based on the number of patients registered and services offered. Clinics in the control group will receive an audit on a selection of AA indicators and will be offered the intervention 12 to 18 months following their recruitment. Data collection and analysis will include quantitative data based on a comprehensive assessment of both AA processes and outcomes. These will be measured through a self-reflective survey for PHC team members, EMR data and patients related outcomes questionnaire on access. Qualitative data based on semi-structured interviews with key stakeholders, observations of the CQI activities and analysis of plans of action of documents plan of action will take place.

Conditions

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Primary Health Care

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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CQI intervention

The proposed CQI cohort consists of three activities carried out iteratively until the improvement objectives are achieved.

Group Type EXPERIMENTAL

CQI intervention

Intervention Type OTHER

Activity 1: Reflective sessions and problem prioritisation. Activity 2: PDSA cycles. Activity 3: Group mentoring.

Audit and feedback

Clinics in the control group will receive feedback on six key AA indicators, patients reported experience about access and selected AA processes.

Group Type ACTIVE_COMPARATOR

Audit and Feedback

Intervention Type OTHER

Audit and Feedback on six key AA indicators, patients reported experience about access and selected AA processes.

Interventions

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CQI intervention

Activity 1: Reflective sessions and problem prioritisation. Activity 2: PDSA cycles. Activity 3: Group mentoring.

Intervention Type OTHER

Audit and Feedback

Audit and Feedback on six key AA indicators, patients reported experience about access and selected AA processes.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Clinics must offer interprofessional care.
* At least 50 % of all team members should accept to take part in the study.

Exclusion Criteria

* Solo Practice Physicians
* Physician-nurse only model
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Isabelle Gaboury

UNKNOWN

Sponsor Role collaborator

Mike Green

UNKNOWN

Sponsor Role collaborator

Tara Kiran

UNKNOWN

Sponsor Role collaborator

Janusz Kaczorowski

UNKNOWN

Sponsor Role collaborator

Maude Laberge

UNKNOWN

Sponsor Role collaborator

Université de Sherbrooke

OTHER

Sponsor Role lead

Responsible Party

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Mylaine Breton

Associate Professor, Department of Community Health Sciences

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mylaine Breton, PhD

Role: PRINCIPAL_INVESTIGATOR

Université de Sherbrooke

Locations

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CISSS de la Gaspésie

Gaspé, Quebec, Canada

Site Status RECRUITING

CISSS de l'Outaouais

Gatineau, Quebec, Canada

Site Status RECRUITING

CISSS de Lanaudière

Joliette, Quebec, Canada

Site Status RECRUITING

CISSS de Laval

Laval, Quebec, Canada

Site Status RECRUITING

CISSS de Chaudière-Appalaches

Lévis, Quebec, Canada

Site Status RECRUITING

CIUSSS de Montérégie-Centre

Longueuil, Quebec, Canada

Site Status RECRUITING

CIUSSS de l'Est-de-l'Île-de-Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

CIUSSS de l'Ouest-de-l'Île-de-Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

CIUSSS du Centre-Ouest-de-l'Île-de-Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

CIUSSS du Centre-Sud-de-l'Île-de-Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

CIUSSS du Nord-de-l'Île-de-Montréal

Montreal, Quebec, Canada

Site Status RECRUITING

CISSS de l'Abitibi-Témiscamingue

Rouyn-Noranda, Quebec, Canada

Site Status RECRUITING

CISSS de la Montérégie-Ouest

Saint-Hubert, Quebec, Canada

Site Status RECRUITING

CISSS de la Montérégie-Est

Saint-Hyacinthe, Quebec, Canada

Site Status RECRUITING

CISSS des Laurentides

Saint-Jérôme, Quebec, Canada

Site Status RECRUITING

CIUSSS de l'Estrie-CHUS

Sherbrooke, Quebec, Canada

Site Status RECRUITING

CIUSSS de la Mauricie et Centre-du-Québec

Trois-Rivières, Quebec, Canada

Site Status RECRUITING

CIUSSS de la Capitale-Nationale

Québec, , Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Elisabeth Martin, Ph.D(c)

Role: CONTACT

5147799926

Facility Contacts

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Role: primary

819 966-6000 ext. 339199

Role: primary

Chantal Legris

Role: primary

Role: primary

418 835-7121 ext. 11360

Helene Langelier

Role: primary

450 466.5000 ext. 3894

Sara Appadu

Role: primary

514 252-3400 ext. 5708

Serina Giagnotti

Role: primary

514-340-8222 ext. 26785

Valerie Barbin

Role: primary

(450) 445-2431 ext. 2281

Julie Desormeau

Role: primary

Sonia Drolet

Role: backup

Marie-Ève Lapointe

Role: primary

Lisa Veilleux

Role: primary

Role: primary

819 478-6464 ext. 26478

Olivier Contensou

Role: primary

References

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Breton M, Gaboury I, Martin E, Green ME, Kiran T, Laberge M, Kaczorowski J, Ivers N, Deville-Stoetzel N, Bordeleau F, Beaulieu C, Descoteaux S. Impact of externally facilitated continuous quality improvement cohorts on Advanced Access to support primary healthcare teams: protocol for a quasi-randomized cluster trial. BMC Prim Care. 2023 Apr 11;24(1):97. doi: 10.1186/s12875-023-02048-y.

Reference Type DERIVED
PMID: 37038126 (View on PubMed)

Other Identifiers

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MP-04-2022-696

Identifier Type: -

Identifier Source: org_study_id

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