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Research ArticleOriginal Research

Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment?

Lyle J. Fagnan, Theresa L. Walunas, Michael L. Parchman, Caitlin L. Dickinson, Katrina M. Murphy, Ross Howell, Kathryn L. Jackson, Margaret B. Madden, James R. Ciesla, Kathryn D. Mazurek, Abel N. Kho and Leif I. Solberg
The Annals of Family Medicine April 2018, 16 (Suppl 1) S72-S79; DOI: https://doi.org/10.1370/afm.2199
Lyle J. Fagnan
1Oregon Rural Practice-based Research Network (ORPRN), Portland, Oregon
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Theresa L. Walunas
2Department of Medicine and Center for Health Information Partnerships, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Michael L. Parchman
3Kaiser Permanente Washington Health Research Institute, MacColl Center for Health Care Innovation, Seattle, Washington
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Caitlin L. Dickinson
1Oregon Rural Practice-based Research Network (ORPRN), Portland, Oregon
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Katrina M. Murphy
1Oregon Rural Practice-based Research Network (ORPRN), Portland, Oregon
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Ross Howell
4Qualis Health, Seattle, Washington
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Kathryn L. Jackson
2Department of Medicine and Center for Health Information Partnerships, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Margaret B. Madden
2Department of Medicine and Center for Health Information Partnerships, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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James R. Ciesla
5College of Health and Human Sciences, Northern Illinois University, DeKalb, Illinois
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Kathryn D. Mazurek
5College of Health and Human Sciences, Northern Illinois University, DeKalb, Illinois
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Abel N. Kho
2Department of Medicine and Center for Health Information Partnerships, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Leif I. Solberg
6HealthPartners Institute, Bloomington, Minnesota
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Abstract

PURPOSE The methods and costs to enroll small primary care practices in large, regional quality improvement initiatives are unknown. We describe the recruitment approach, cost, and resources required to recruit and enroll 500 practices in the Northwest and Midwest regional cooperatives participating in the Agency for Healthcare Research and Quality (AHRQ)-funded initiative, EvidenceNOW: Advancing Heart Health in Primary Care.

METHODS The project management team of each cooperative tracked data on recruitment methods used for identifying and connecting with practices. We developed a cost-of-recruitment template and used it to record personnel time and associated costs of travel and communication materials.

RESULTS A total of 3,669 practices were contacted during the 14- to 18-month recruitment period, resulting in 484 enrolled practices across the 6 states served by the 2 cooperatives. The average number of interactions per enrolled practice was 7, with a total of 29,100 hours and a total cost of $2.675 million, or $5,529 per enrolled practice. Prior partnerships predicted recruiting almost 1 in 3 of these practices as contrasted to 1 in 20 practices without a previous relationship or warm hand-off.

CONCLUSIONS Recruitment of practices for large-scale practice quality improvement transformation initiatives is difficult and costly. The cost of recruiting practices without existing partnerships is expensive, costing 7 times more than reaching out to familiar practices. Investigators initiating and studying practice quality improvement initiatives should budget adequate funds to support high-touch recruitment strategies, including building trusted relationships over a long time frame, for a year or more.

  • primary care practices
  • quality improvement
  • cost
  • recruitment

Footnotes

  • Conflicts of interest: authors report none.

  • Funding support: Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ) through contract No. HHSA290201200019I, and grant Nos. R18 HS023921 and R18 HS023908.

  • Disclaimer: This work represents the opinions of the authors and should not be interpreted as official positions of the Agency for Healthcare Research and Quality or the US Department of Health and Human Services.

  • Previous presentations: Abstract presented at North American Primary Care Research Group 2016 Practice-based Research Network Conference; July 11–12, 2016; Bethesda, Maryland.

  • Supplementary materials: Available at http://www.AnnFamMed.org/content/16/Suppl_1/S72/suppl/DC1/.

  • © 2018 Annals of Family Medicine, Inc.
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Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment?
Lyle J. Fagnan, Theresa L. Walunas, Michael L. Parchman, Caitlin L. Dickinson, Katrina M. Murphy, Ross Howell, Kathryn L. Jackson, Margaret B. Madden, James R. Ciesla, Kathryn D. Mazurek, Abel N. Kho, Leif I. Solberg
The Annals of Family Medicine Apr 2018, 16 (Suppl 1) S72-S79; DOI: 10.1370/afm.2199

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Engaging Primary Care Practices in Studies of Improvement: Did You Budget Enough for Practice Recruitment?
Lyle J. Fagnan, Theresa L. Walunas, Michael L. Parchman, Caitlin L. Dickinson, Katrina M. Murphy, Ross Howell, Kathryn L. Jackson, Margaret B. Madden, James R. Ciesla, Kathryn D. Mazurek, Abel N. Kho, Leif I. Solberg
The Annals of Family Medicine Apr 2018, 16 (Suppl 1) S72-S79; DOI: 10.1370/afm.2199
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  • The Role of Health Extension in Practice Transformation and Community Health Improvement: Lessons From 5 Case Studies
  • Technical Assistance for Primary Care Practice Transformation: Free Help to Perform Unpaid Labor?
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