Systems change: Recruiting community clinics

Plan: Step 3
This process has four elements:
  1. Plan:
       a. Step 1.
       b. Step 2.
       c. Step 3.
       d. Step 4.
  2. Do:
       a. Step 1.
       b. Step 2.
  3. Study.
  4. Act.
Now that you’re familiar with chronic diseases and the systems change approach, the next step is identifying clinics in your community that are interested in implementing systems change strategies. Use your network to identify clinics that are poised to make systems changes. Often, this sort of project works well if the clinic has implemented or shown interest in other quality improvement efforts. Once you have a list of possible partners, organize meetings with the clinics’ decision-makers, such as the medical director, office manager and other key staff.
Things to consider when selecting a clinic to engage
  • Established relationships between your organization’s management and that of the clinic.
  • Needed improvements to the clinic’s screening policies and practices.
  • Characteristics of the clinic (size, type, number of patients served).
  • Characteristics of the clinic’s patient population (insured versus uninsured).
  • Obstacles that may prevent or deter the clinic from implementing systems change (limited resources, time constraints, other ongoing projects).
  • Existing or potential “clinic champions” (someone to head up the intervention on the clinic side).
  • Commitment of the clinic’s leadership to increasing chronic disease prevention.
  • Local capacity of endoscopic screening providers.
  • Partnerships between clinic and local cancer treatment providers.
Adapted from Working With Healthcare Delivery Systems to Improve the Delivery of Tobacco-use Treatment to Patient: An Action Guide.
Clinic talking points
Why should a clinic be interested in systems change/quality improvement for chronic disease? Here are a few talking points to use when recruiting clinics:
  • Baseline assessments are opportunities to capture current screening rates and to set goals for improvement. Reassessing screening rates can demonstrate whether quality improvement efforts are successful.
  • Gathering screening data can help in reporting required measures, such as National Quality Forum (NQF) and Uniform Data System (UDS).
  • Implementing a system change approach can help them reach more patients in a sustainable way.