Teaching performance improvement to residency programs and community health centers: Findings from an evaluation of the residency program and community health center collaborative

The Pennsylvania Residency Program and Community Health Center Collaborative (RPCHC Collaborative) is a statewide learning collaborative that joins primary care providers, residents, and clinical and administrative support staff from residency programs and community health centers to learn and share strategies for practice transformation and quality improvement. As a part of the collaborative, quality improvement teams from practices are led by physician mentors and engage in a number of learning activities and data reporting; team members work together to achieve NCQA Patient-Centered Medical Home recognition and to help transform practices using the Chronic Care Model. This collaborative learning model aims to: (1) enhance care delivered to patients with diabetes and cardiovascular disease; (2) improve patient health outcomes including A1C, blood pressure, and cholesterol control; and (3) strengthen the primary care workforce. In September 2011, the Centers for Disease Control and Prevention funded an evaluation to assess the effectiveness of this program in achieving outcomes and to inform the replicability of this program in other settings. This evaluation utilized a mixed-method approach. Qualitative data used for this evaluation included document review, in-depth interviews, and observation of program implementation. Quantitative data utilized included program implementation tracking data and aggregate clinical process and outcome data as reported by participating practices. Thematic analysis was used to analyze qualitative data, and descriptive, bivariate, and regression analyses were used to analyze quantitative data. Through detailed exploration of program implementation, the research team identified factors to consider when replicating this program in other settings. These factors included a definition of the target audience, goals and objectives to be achieved, and strategies that can be used to achieve success. Findings from the evaluation offer an in-depth understanding for how the RPCHC Collaborative provides participating practices with a framework for continuous quality improvement and contributes to practices' ability to achieve outcomes related to quality improvement and patient health.