Clinician Perspectives on the Benefits of Practice Facilitation for Small Primary Care Practices

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Figure 1
Interview recruitment diagram.
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Figure 2
Themes related to the perceived benefits and roles of external practice facilitation for small independent primary care practices.
EHR = electronic health record; PCMH = patient-centered medical home; QI = quality improvement.
^aBenefits solely or more frequently discussed by practices with ≤3 office staff.
Note: Ovals with solid outlines represent 2 main perceived benefits of practice facilitators: external connection and EHR expertise. Ovals with dotted outlines represent perceived roles of practice facilitators: teacher and support staff. At the intersection of these main benefits and roles, there emerged 3 centralized benefits, represented by the center circle.

Table 1

Characteristics of Participating Clinicians and Their Practices and Patients

Characteristic	Practice Size^a
Characteristic	≤3 Office Staff (n = 11)	>3 Office Staff (n = 8)
Clinicians (N = 19)
Male sex, No. (%)	6 (55)	5 (63)
Clinical role, No. (%)
Physician (MD, DO)	11 (100)	7 (87)
Other	0 (0)	1 (13)
Years at current location, mean (SD)	16.7 (11.9)	15.3 (10.0)
Practices (N = 19)
Size, No. (%)
Solo	8 (73)	3 (37)
>2 clinicians	2 (18)	5 (63)
Missing	1 (9)	0 (0)
Clinician owned, No. (%)	11 (100)	8 (100)
Number of FTE clinicians, mean (SD)	1.4 (0.5)	2.8 (2.8)
Number of FTE clinical staff, median (IQR)	3.0 (1.8)	2.0 (1.5)
Number of FTE office staff, median (IQR)	3.0 (1.5)	4.5 (2.3)
Years with PCIP, mean (SD)	9.0 (1.9)	9.5 (1.3)
PCMH recognition, No. (%)
Current	9 (82)	6 (74)
Former	1 (9)	1 (13)
Never	1 (9.1)	1 (13)
Location in New York City, No. (%)
Bronx	3 (27)	2 (25)
Brooklyn	4 (36)	0 (0)
Manhattan	1 (9)	3 (38)
Queens	2 (18)	2 (25)
Staten Island	1 (9)	1 (13)
Baseline performance: ABC composite, % (SD)	42 (24)	49 (20)
Patient population
Proportion of patients with Medicaid as sole or primary insurance, mean % (SD)	42 (33)	46 (32)
Proportion of patients of nonwhite race, mean % (SD)	76 (34)	86 (15)

ABC = aspirin, blood pressure, cholesterol; DO = doctor of osteopathy FTE = full-time equivalent, IQR = interquartile range; MD = doctor of medicine; PCIP = Primary Care Information Project; PCMH = patient-centered medical home.
Note: ABC composite was proportion of patients in a practice with a history of atherosclerotic cardiovascular disease who met treatment targets for 3 of the 4 Million Hearts outcomes (defined as receiving aspirin and statin therapy and having their blood pressure controlled to <140/90 mm Hg).
↵a Based on FTEs of internal staff available for quality improvement.