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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Practice Facilitation for Primary Care

Approach. Develop a practice facilitation program to connect practice coaches with primary care clinics.

Source. Robert Wood Johnson Foundation's What Works for Health (WWFH) Database

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Overview. Practice facilitation efforts include comprehensive approaches to help ensure care timeliness, improve continuity of care, improve preventive and chronic care, and increase practice efficiency and patient-centeredness. (CWF-Grumbach 2012). Efforts are led by practice coaches or facilitators who work with clinic staff to redesign clinical practices and improve the quality of care delivered.

Evidence. Scientifically Supported. Practices that work with coaches appear to deliver more preventive services including screenings for breast, cervical, and colorectal cancers (Wang 2018a) and provide better and more frequent primary care than practices that do not (Wang 2018a, CWF-Grumbach 2012). Read more in theĀ WWFH database report. Read more about WWFH's evidence ratings. (*Links to citations can be accessed through the WWFH database).

Target Audience. Systems.

Outcome. Percent of women, ages 18 through 44, with a preventive medical visit in the past year.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Develop a practice facilitation program to connect practice coaches with primary care clinics,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of primary care clinics working with a practice coach.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of primary care clinics working with a practice coach.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of primary care clinics with QI initiatives focused on the enhancement of access to preventive care services.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of primary care clinics with QI initiatives focused on the enhancement of access to preventive care services.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


 

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.