Effects of Facilitated Team Meetings and Learning Collaboratives on Colorectal Cancer Screening Rates in Primary Care Practices: A Cluster Randomized Trial

The Article in Brief

Effects of Facilitated Team Meetings and Learning Collaboratives on Colorectal Cancer Screening Rates in Primary Care Practices: A Cluster Randomized Trial

Eric K. Shaw , and colleagues

Background This study evaluates a practice-based quality improvement intervention. Practices were given a specific goal (to improve colorectal cancer screening rates) and a change process (a series of facilitated team meetings and learning collaboratives), and were allowed to generate their own quality improvement objectives and strategies in hopes of enhancing their capacity for change.

What This Study Found Among 23 primary care practices, there was no significant improvement in screening rates in intervention practices compared with control practices. Successful implementation of the quality improvement program did not always translate into improved screening rates. There were associations between how well practice leaders fostered team development and the extent to which team members felt safe to engage in the change process. High-performing practices appeared to improve their capacity for change more than low-performing practices through the use of a reflective adaptive process.

Implications

• Practice transformation cannot be realized through only a series of incremental quality improvement projects. Developing greater organizational learning and change capacities is required.
• The quality improvement approach used in this study (Multimethod Assessment Process, Reflective Adaptive Process, facilitated team meetings, and learning collaboratives) may not be an optimal strategy for single-target interventions, particularly if gains in short-term guidelines are the goal.
• The researchers call for future research to address not only whether quality improvement interventions work but also why they work.