Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty

Abstract Background Practice based research and learning networks (PBRLNs) are groups of learning communities that focus on improving delivery and quality of care. Accurate data from primary care electronic medical records (EMRs) is crucial in forming the backbone for PBRLNs. The purpose of this wor...

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Autores principales:	Manpreet Thandi, Sabrina T. Wong, Sylvia Aponte-Hao, Mathew Grandy, Dee Mangin, Alexander Singer, Tyler Williamson
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Practice-based research and learning networks Learning health systems Primary care Frailty Multi-jurisdictional collaboration Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/8b55030ef8cd45c7abb64c2957b94767
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spelling	oai:doaj.org-article:8b55030ef8cd45c7abb64c2957b947672021-11-14T12:32:27ZStrategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty10.1186/s12875-021-01573-y1471-2296https://doaj.org/article/8b55030ef8cd45c7abb64c2957b947672021-11-01T00:00:00Zhttps://doi.org/10.1186/s12875-021-01573-yhttps://doaj.org/toc/1471-2296Abstract Background Practice based research and learning networks (PBRLNs) are groups of learning communities that focus on improving delivery and quality of care. Accurate data from primary care electronic medical records (EMRs) is crucial in forming the backbone for PBRLNs. The purpose of this work is to: (1) report on descriptive findings from recent frailty work, (2) describe strategies for working across PBRLNs in primary care, and (3) provide lessons learned for engaging PBRLNs. Methods We carried out a participatory based descriptive study that engaged five different PBRLNs. We collected Clinical Frailty Scale scores from a sample of participating physicians within each PBRLN. Descriptive statistics were used to analyze frailty scores and patients’ associated risk factors and demographics. We used the Consolidated Framework for Implementation Research to inform thematic analysis of qualitative data (meeting minutes, notes, and conversations with co-investigators of each network) in recognizing challenges of working across networks. Results One hundred nine physicians participated in collecting CFS scores across the five provinces (n = 5466). Percentages of frail (11-17%) and not frail (82-91%) patients were similar in all networks, except Ontario who had a higher percentage of frail patients (25%). The majority of frail patients were female (65%) and had a significantly higher prevalence of hypertension, dementia, and depression. Frail patients had more prescribed medications and numbers of healthcare encounters. There were several noteworthy challenges experienced throughout the research process related to differences across provinces in the areas of: numbers of stakeholders/staff involved and thus levels of burden, recruitment strategies, data collection strategies, enhancing engagement, and timelines. Discussion Lessons learned throughout this multi-jurisdictional work included: the need for continuity in ethics, regular team meetings, enhancing levels of engagement with stakeholders, the need for structural support and recognizing differences in data sharing across provinces. Conclusion The differences noted across CPCSSN networks in our frailty study highlight the challenges of multi-jurisdictional work across provinces and the need for consistent and collaborative healthcare planning efforts.Manpreet ThandiSabrina T. WongSylvia Aponte-HaoMathew GrandyDee ManginAlexander SingerTyler WilliamsonBMCarticlePractice-based research and learning networksLearning health systemsPrimary careFrailtyMulti-jurisdictional collaborationMedicine (General)R5-920ENBMC Family Practice, Vol 22, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Practice-based research and learning networks Learning health systems Primary care Frailty Multi-jurisdictional collaboration Medicine (General) R5-920
spellingShingle	Practice-based research and learning networks Learning health systems Primary care Frailty Multi-jurisdictional collaboration Medicine (General) R5-920 Manpreet Thandi Sabrina T. Wong Sylvia Aponte-Hao Mathew Grandy Dee Mangin Alexander Singer Tyler Williamson Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
description	Abstract Background Practice based research and learning networks (PBRLNs) are groups of learning communities that focus on improving delivery and quality of care. Accurate data from primary care electronic medical records (EMRs) is crucial in forming the backbone for PBRLNs. The purpose of this work is to: (1) report on descriptive findings from recent frailty work, (2) describe strategies for working across PBRLNs in primary care, and (3) provide lessons learned for engaging PBRLNs. Methods We carried out a participatory based descriptive study that engaged five different PBRLNs. We collected Clinical Frailty Scale scores from a sample of participating physicians within each PBRLN. Descriptive statistics were used to analyze frailty scores and patients’ associated risk factors and demographics. We used the Consolidated Framework for Implementation Research to inform thematic analysis of qualitative data (meeting minutes, notes, and conversations with co-investigators of each network) in recognizing challenges of working across networks. Results One hundred nine physicians participated in collecting CFS scores across the five provinces (n = 5466). Percentages of frail (11-17%) and not frail (82-91%) patients were similar in all networks, except Ontario who had a higher percentage of frail patients (25%). The majority of frail patients were female (65%) and had a significantly higher prevalence of hypertension, dementia, and depression. Frail patients had more prescribed medications and numbers of healthcare encounters. There were several noteworthy challenges experienced throughout the research process related to differences across provinces in the areas of: numbers of stakeholders/staff involved and thus levels of burden, recruitment strategies, data collection strategies, enhancing engagement, and timelines. Discussion Lessons learned throughout this multi-jurisdictional work included: the need for continuity in ethics, regular team meetings, enhancing levels of engagement with stakeholders, the need for structural support and recognizing differences in data sharing across provinces. Conclusion The differences noted across CPCSSN networks in our frailty study highlight the challenges of multi-jurisdictional work across provinces and the need for consistent and collaborative healthcare planning efforts.
format	article
author	Manpreet Thandi Sabrina T. Wong Sylvia Aponte-Hao Mathew Grandy Dee Mangin Alexander Singer Tyler Williamson
author_facet	Manpreet Thandi Sabrina T. Wong Sylvia Aponte-Hao Mathew Grandy Dee Mangin Alexander Singer Tyler Williamson
author_sort	Manpreet Thandi
title	Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
title_short	Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
title_full	Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
title_fullStr	Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
title_full_unstemmed	Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
title_sort	strategies for working across canadian practice-based research and learning networks (pbrlns) in primary care: focus on frailty
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8b55030ef8cd45c7abb64c2957b94767
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Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty

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