Primary care practice-based research networks: Innovations for learning and improvement within networks

Background: A continuing challenge in public health is the delay of translating research into practice. Primary care Practice-Based Research Networks (PBRNs) offer a way forward to shorten this gap. PBRNs are groups of primary care offices/clinics that collaborate to answer research questions relevant to the delivery of primary care. The Agency for Healthcare Research and Quality (AHRQ) has supported a PBRN program for many years and there are currently over 130 PBRNs in the US. PBRNs operate in diverse geographical settings, focus on a variety of health conditions and conduct studies ranging from clinical trials to implementation research. The purpose of this research is to identify and describe innovative methods and strategies used by PBRNs to foster learning and improvement across primary care delivery systems. Methods: Data were collected from four sources: 1) a comprehensive review of published and grey literature; 2) discussions with PBRN directors identified as key informants within the PBRN community; 3) a technical expert panel; and 4) the 2012 and 2013 surveys of PBRNs registered with the AHRQ PBRN Resource Center. Iterative constant comparative analysis was applied to findings abstracted from the literature review along with notes and transcripts from interviews and technical expert panel meetings. Preliminary findings were reviewed by the technical expert panel and revised based on feedback obtained. Findings: Results of the analysis of the literature review, interviews and TEP feedback suggest that PBRN activities promote learning on three levels: quality improvement, individual clinician education on a specific clinical topic, and research results. The majority of PBRNs offer opportunities to participate in developing and publishing research and employ internal and external dissemination strategies such as network meetings, newsletters, and websites. In addition, a large proportion of PBRNs organize CME and opportunities to participate in learning collaboratives. Some PBRNs use additional approaches including academic detailing and practice facilitation/coaching. PBRN organization and interests vary greatly, so the content and structure of learning activities reflect member practice research interests and opportunities afforded by funding. Establishing a shared vision is one strategy that PBRN leaders pursue in order to make and prioritize methods to enhance connections between offices/clinics in order to foster learning and innovation. Conclusions: PBRNs promote learning and improvement through locally tailored strategies. Further research is needed to know which activities are most effective in spreading innovations and ultimately improving the quality of care for patients.