The Role of the Champion in Primary Care Change Efforts: From the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP)

被引:143
作者
Shaw, Eric K. [1 ]
Howard, Jenna [2 ]
West, David R. [3 ]
Crabtree, Benjamin F. [2 ,4 ]
Nease, Donald E., Jr. [3 ]
Tutt, Brandon [3 ]
Nutting, Paul A. [3 ]
机构
[1] Mercer Univ, Sch Med, Dept Community Med, Savannah, GA 31404 USA
[2] Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Dept Family Med & Community Hlth, Somerset, NJ USA
[3] Univ Colorado, Hlth Sci Ctr, Dept Family Med, Aurora, CO USA
[4] Canc Inst New Jersey, New Brunswick, NJ USA
关键词
Diabetes Mellitus; Practice-based Research; Practice-based Research Networks; Primary Health Care; Quality Improvement; INFLUENZA VACCINATION; ENVIRONMENTS; INNOVATION; QUALITY; PROGRAM;
D O I
10.3122/jabfm.2012.05.110281
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Change champions are important for moving new innovations through the phases of initiation, development, and implementation. Although research attributes positive health care changes to the help of champions, little work provides details about the champion role. Methods: Using a combination of immersion/crystallization and matrix techniques, we analyzed qualitative data, which included field notes of team meetings, interviews, and transcripts of facilitator meetings, from a sample of 8 practices. Results: Our analysis yielded insights into the value of having 2 discrete types of change champions: (1) those associated with a specific project (project champions) and (2) those leading change for entire organizations (organizational change champions). Relative to other practices under study, those that had both types of champions who complemented each other were best able to implement and sustain diabetes care processes. We provide insights into the emergence and development of these champion types, as well as key qualities necessary for effective championing. Conclusions: Practice transformation requires a sustained improvement effort that is guided by a larger vision and commitment and assures that individual changes fit together into a meaningful whole. Change champions-both project and organizational change champions-are critical players in supporting both innovation-specific and transformative change efforts. (J Am Board Fam Med 2012;25:676-685.)
引用
收藏
页码:676 / 685
页数:10
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