BACKGROUND Chronic conditions such as diabetes and chronic obstructive pulmonary disease (COPD) are common and burdensome diseases primarily managed in primary care. Yet, evidence points to suboptimal quality of care for these conditions in primary care settings. Quality improvement collaboratives (QICs) are organized, multifaceted interventions that can be effective in improving chronic disease care processes and outcomes. In Quebec, Canada, the Institut national d'excellence en santé et en services sociaux (INESSS) has developed a large-scale QIC province-wide program called COMPAS+ that aims to improve the prevention and management of chronic diseases in primary care. This paper describes the protocol for our study, which aims to evaluate implementation and impact of COMPAS+ QICs on the prevention and management of targeted chronic diseases like diabetes and COPD. METHODS This is a mixed-methods, integrated knowledge translation study. The quantitative component involves a controlled interrupted time series involving nine large integrated health centres in the province. Study sites will receive one of two interventions: the multifaceted COMPAS+ intervention (experimental condition) or a feedback only intervention (control condition). For the qualitative component, a multiple case study approach will be used to achieve an in-depth understanding of individual, team, organizational and contextual factors influencing implementation and effectiveness of the COMPAS+ QICs. DISCUSSION COMPAS+ is a QI program that is unique in Canada due to its integration within the governance of the Quebec healthcare system and its capacity to reach many primary care providers and people living with chronic diseases across the province. We anticipate that this study will address several important gaps in knowledge related to large-scale QIC projects and generate strong and useful evidence (e.g., on leadership, organizational capacity, patient involvement, and implementation) having the potential to influence the design and optimisation of future QICs in Canada and internationally.

中文翻译：

---

评估省级初级保健慢性病管理质量改进合作的实施和影响：COMPAS+ 研究方案。


背景技术慢性病例如糖尿病和慢性阻塞性肺病(COPD)是主要在初级保健中管理的常见且繁重的疾病。然而，有证据表明初级保健机构对这些病症的护理质量不佳。质量改进协作 (QIC) 是有组织的、多方面的干预措施，可以有效改善慢性病护理流程和结果。在加拿大魁北克省，国家健康与社会服务卓越研究所 (INESSS) 开发了一项名为 COMPAS+ 的全省范围内的大规模 QIC 计划，旨在改善初级保健中慢性病的预防和管理。本文描述了我们的研究方案，旨在评估 COMPAS+ QIC 对预防和管理糖尿病和慢性阻塞性肺病等目标慢性疾病的实施和影响。方法这是一项混合方法、综合知识翻译研究。定量部分涉及受控中断时间序列，涉及该省九个大型综合卫生中心。研究地点将接受两种干预措施之一：多方面的 COMPAS+ 干预（实验条件）或仅反馈干预（控制条件）。对于定性部分，将使用多个案例研究方法来深入了解影响 COMPAS+ QIC 实施和有效性的个人、团队、组织和背景因素。讨论 COMPAS+ 是一项在加拿大独一无二的 QI 计划，因为它融入了魁北克医疗保健系统的治理，并且能够覆盖全省的许多初级保健提供者和慢性病患者。 我们预计这项研究将解决与大型 QIC 项目相关的几个重要知识空白，并产生强有力的有用证据（例如，关于领导力、组织能力、患者参与和实施），有可能影响 QIC 项目的设计和优化。加拿大和国际上未来的 QIC。