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Local learning collaboratives increased CKD knowledge, skills among clinicians

Local learning collaboratives had a positive impact on most clinicians, particularly when it came to increasing their knowledge of chronic kidney disease, according to study data published in the Journal of American Board of Family Medicine.

However, there were challenges to implementing the local learning collaboratives (LLC) and concern about whether they could be sustained.

Researchers conducted a mixed-methods process evaluation to see if implementing the local learning collaborative (LLC) went as originally intended,  to determine if chronic kidney disease (CKD)-related quality improvement goals were met as a result of the LLC, and to learn the experiences of participating physicians. Eighty-nine practices across four practice-based research networks (PBRNs) took part. LLCs were implemented from three of those four PBRNs, and 20 LLCs held 121 monthly meetings, researchers wrote, with most of them holding the six required meetings. Clinicians made up 54% of the attendees. Lipman and Aspy interviewed 21 clinicians to assess the significance of LLCs.

“Increasing knowledge of CKD was cited frequently as the most significant outcome, particularly CKD screening and the effect of nonsteroidal anti-inflammatory drugs, Paula Darby Lipman, PhD, of the department of family and preventative medicine, University of Oklahoma, and Cheryl B. Aspy, PhD, of the University of Oklahoma Health Sciences Center, wrote. "Meetings had a positive impact on perceived ability to care for patients with CKD. Several clinicians reported improvements in patient education skills and protocols to identify and contact at-risk patients. For those with protocols or systems already in place, participating in meetings provided additional reinforcement and feedback.”

Common themes among participants interviewed for the study included LLC satisfaction, mindsets on their feasibility and the presumed impact of previous relationships and practice similarities. Most participants were pleased with the program, especially when the built on prior relationships, did not require significant travel and when a common health system infrastructure was in place, but the constraints LLCs put on their time and paperwork — which take them away from patients —  were drawbacks.

Researchers wrote participants who felt they had adequate knowledge of CKD or felt they met the standards required of them for the disease found the LLCs less impactful.

“The formation of LLCs may not be feasible or effective in all contexts, even with logistic support. Data collected in this multi-PBRN project indicate that sharing performance data created motivation to improve patient care, attendees learned valuable lessons from each other, and clinicians were actively involved in attempts to improve the implementation of CKD guidelines,” Lipman and Aspy wrote. – by Janel Miller

Disclosure: Lipman and Aspy report no relevant financial disclosures.