In Ontario, Canada, most COVID-19 vaccinations were administered by public health organizations and pharmacies rather than by family physicians. Researchers devised a practice facilitation intervention program to help family physicians proactively engage with their patients who were not yet vaccinated for COVID‐19.
Six trained practice facilitators helped 90 family physicians identify unvaccinated patients and offered resources to address COVID‐19 vaccine hesitancy, scripts and email templates for patient outreach, and connections to trained medical student volunteers to work as physician‐delegates by conducting patient telephone outreach and motivational interviewing. At the end of the four-month intervention, the researchers interviewed both the practice facilitators and the physicians participating in the study about their experiences. They also analyzed quantitative data capturing the amount of time facilitators spent working with participating clinics and the percentage of physicians requesting each type of available support. The results suggest that the most useful service provided by the facilitators was helping physicians identify unvaccinated patients; medical students who shared a language or cultural background with patients were also appreciated. Barriers to implementing practice facilitation included resistance by physicians and/or staff and time required for onboarding and training. The most popular types of support, such as robocalls to patients, required minimal engagement and time commitments from physicians and clinic staff.
What We Know: Family physicians play an essential role in educating their patients about vaccinations, encouraging vaccine uptake, addressing hesitancies, and debunking misinformation. However, as with other types of care, they may face barriers such as time constraints, tight budgets, and staffing issues to following best practices for providing vaccinations. COVID-19 brought significant changes to the practice of family medicine, adding to physicians' feelings of burnout and limiting their time and resources to discuss evolving vaccination information with their patients.
What This Study Adds: Practice facilitation can help primary care clinics adopt best practices for patient care, including providing vaccinations. Being unable to identify patients who had not received COVID-19 vaccinations posed a problem and receiving technical help in identifying those patients was the most important resource for primary care doctors. Additionally, researchers found that programs should be tailored to the needs of individual clinics and the populations they serve. They should provide new services and resources without significantly increasing the workloads of physicians and clinic staff; among the most popular supports used in this study were the assistance of medical student volunteers and robocalls to patients about the COVID-19 vaccine.
Practice Facilitation to Support Family Physicians in Encouraging COVID‐19 Vaccine Uptake: A Multi‐Method Process Evaluation
Jennifer Shuldiner, PhD, et al
Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, Ontario, Canada
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