Adapting the MUSIQ Calculator for Practice Facilitators to Evaluate Primary Care Clinic Performance in a Colorectal Cancer Screening Quality Improvement Project.

Abstract

The Model for Understanding Success in Quality (MUSIQ) is a framework designed to understand the contextual factors that can influence healthcare quality improvement (QI) initiative implementation. The MUSIQ calculator was originally developed to help clinics identify contextual factors that may affect QI success. This retrospective study adapted the MUSIQ calculator to serve as an evaluative tool for practice facilitators engaged in a colorectal cancer screening initiative. Eight primary care clinics were scored in 6 contextual factors categories using the adapted MUSIQ calculator. Average MUSIQ scores were used to identify high and low contextual factors clinics, and their colorectal cancer screening rates were assessed across a 4-year period of active engagement with the colorectal cancer screening initiative. There were statistically significant, strong, correlations between overall contextual factors scores and colorectal cancer screening rates across all 4 years. There was a statistically significant difference between screening rate changes during the period of active engagement and high or low contextual factors scores (<i>P</i> = .047). There were statistically significant correlations between 3 contextual factors and colorectal cancer screening rate changes with "Microsystem" and "QI Support" having the strongest associations (<i>P</i> < .001). Low or high contextual factors classification statistically significantly predicted colorectal cancer screening rate changes across the observed timeframe (<i>P</i> = .047). By adapting existing tools with a strong track record of success, like MUSIQ, practice facilitators can identify potential challenges earlier in the QI process providing an important opportunity to intervene to prompt greater success.