Purpose: There are numerous supportive quality improvement (QI) projects to facilitate the implementation of evidence-based practices in primary care, but recruiting physician practices to join these projects is challenging, costly, and time consuming. We aimed to identify factors leading primary care practices to decline participation in QI projects, and strategies to improve the feasibility and attractiveness of QI projects in the future.
Methods: For this qualitative study, we contacted 109 representatives of practices that had declined participation in 1 of 4 Agency for Healthcare Research and Quality-funded EvidenceNOW projects. The representatives were invited to participate in a 15-minute interview or complete a 5-question questionnaire. Thematic analysis was used to organize and characterize findings.
Results: Representatives from 31 practices (28.4% of those contacted) responded. Overwhelmingly, respondents indicated that staff turnover, staffing shortages, and general time constraints, exacerbated by the pandemic, prevented participation in the QI projects. Challenges with electronic health records, an expectation of greater financial compensation for participation, and confidence in the practices' current care practices were secondary reasons for declining participation. Tying participation to value-based programs and offering greater compensation were identified as strategies to facilitate recruitment. None of the respondents' recommendations, however, addressed the primary issues of staffing challenges and time constraints.
Conclusions: Staffing challenges and general time constraints, exacerbated by the pandemic, are compromising primary care practices' ability to engage in QI research projects. To encourage participation, policy makers should consider direct supports for primary care, which may also help to alleviate burnout.
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http://dx.doi.org/10.1370/afm.3007 | DOI Listing |
Sci Rep
January 2025
Center of Excellence for Antimicrobial Resistance and Stewardship, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
The pathogenic oomycete Pythium insidiosum causes a fatal infectious illness known as pythiosis, impacting humans and certain animals in numerous countries in the tropics and subtropics. Delayed diagnosis is a primary factor contributing to the heightened morbidity and mortality associated with the disease. Several new serodiagnostic methods have been developed to improve the identification of pythiosis.
View Article and Find Full Text PDFJ Occup Rehabil
January 2025
Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
Purpose: Workers' compensation claims can negatively affect the wellbeing of injured workers. For some, these negative effects continue beyond finalisation of the workers' compensation claim. It is unclear what factors influence wellbeing following finalisation of a workers' compensation claim.
View Article and Find Full Text PDFPediatr Cardiol
January 2025
Division of Cardiac Critical Care, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Neonates with congenital heart disease (CHD) who undergo cardiopulmonary bypass (CPB) are at high-risk for unfavorable neurodevelopmental (ND) outcomes and are recommended for ND evaluation (NDE); however, poor rates have been reported. We aimed to identify risk factors associated with lack of NDE. This single-center retrospective observational study included neonates < 30 days old who underwent CPB and survived to discharge between 2012 and 2018.
View Article and Find Full Text PDFInt Urogynecol J
January 2025
Department of Urology, Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Introduction And Hypothesis: This study was aimed at evaluating the therapeutic effects of a modified intravesical botulinum toxin injection technique (fewer injection sites under local anesthesia), in comparison with the conventional technique for patients with idiopathic detrusor overactivity, considering the urodynamic parameters.
Methods: In this double-blinded randomized clinical trial, 78 adult females with idiopathic detrusor overactivity were divided into two groups: conventional and modified groups. In the conventional method, patients received intradetrusor botulinum toxin injection at 20 sites under general or spinal anesthesia in a trigone-sparing fashion.
Sci Rep
January 2025
Department of Critical Care Medicine, Tongde Hospital of Zhejiang Province, #234 Gucui Road, Hangzhou, 310012, Zhejiang, People's Republic of China.
The intestinal barrier function is a critical defense mechanism in the human body, serving as both the primary target and initiating organ in cases of sepsis. Preserving the integrity of this barrier is essential for preventing complications and diseases, including sepsis and mortality. Despite this importance, the impact of resveratrol on intestinal barrier function remains unclear.
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