Practice Facilitation to Improve Diabetes Care in Primary Care: A Report From the EPIC Randomized Clinical Trial

There is sufficient evidence that facilitation is an effective strategy to assist community based practices to improve the delivery of primary care services to their patients. But how does it work? Which approach to facilitation is most effective in what circumstances? What is the intensity and duration of facilitation needed to address different quality improvement challenges? Are the improvements sustained? Dickinson et al should be congratulated for having taken facilitation research to the next level and shedding light on how it works. Their choice to focus on a single disease can be criticized as not representative of real world family practice but it allowed them to focus their inquiry and test their complex hypotheses in a way that would probably not have been possible in a study targeting all patients with chronic illness (s). Similarly their decision to use a composite of technical quality of care process indicators from chart reviews was practical and allowed them the precision needed to address their sophisticated hypotheses. Bravo for an "EPIC" contribution to the facilitation literature.

Competing interests: ?? None declared