An Approach to Evaluating Multisector Partnerships to Support Evidence-Based Quality Improvement in Primary Care.

BACKGROUND: Quality improvement (QI) interventions in primary care are increasingly designed and implemented by multisector partnerships, yet little guidance exists on how to best monitor or evaluate these partnerships. The goal of this project was to describe an approach for evaluating the development and effectiveness of a multisector partnership using data from the first year of the Healthy Hearts for Michigan (HH4M) Cooperative, a multisector partnership of nine organizations tasked with designing and implementing evidence-based QI strategies for hypertension management and tobacco cessation in 50 rural primary care practices. METHODS: The researchers developed a 49-item online survey focused on factors that facilitate or hinder multisector partnerships, drawing on implementation science and partnership, engagement, and collaboration research. The team surveyed all 44 members of the HH4M Cooperative (79.5% response rate) and conducted interviews with 14 members. The interviews focused on implementation phase-specific goals, accomplishments, and challenges. Descriptive analysis was used for the survey results, and thematic analysis for the interview data. RESULTS: Respondents reported strong overall performance by the Cooperative during its first year, which facilitated the successful completion of several intervention design tasks. Strengths included having a clear purpose and trust and respect among members. Areas for improvement included a need for common terminology, clarification of roles and functions, and improvement in communication across workgroups. Lack of engagement from physician practices due to capacity constraints, exacerbated by the COVID-19 pandemic, was the Cooperative's biggest challenge. CONCLUSION: This multimethod approach to evaluating the development and effectiveness of a multisector partnership yielded practical, actionable feedback to program leaders.

Virtual Delivery of Therapeutic Assessment: An Empirical Case Study.

The Therapeutic Assessment (TA) model of psychological assessment has grown in use due to the demonstrated benefits to clients. However, to date, there have been no published articles on how conducting TA virtually may impact the process and experience. The COVID-19 global pandemic led to a rapid increase in virtual delivery of psychological services, including assessments. Assessors adapted procedures to ensure that clients were served ethically, the assessor-client relationship was considered, and the results were deemed valid. This empirical case study was conducted to evaluate test validity, therapeutic alliance, and the clinician's and client's experience of a TA conducted virtually. The validity of test administration was evaluated by experts, who reviewed video of the administration and test results; no concerns regarding integrity and interpretability of the results were identified. Therapeutic alliance, session process, and virtual presence were measured after each session. Both clinician and client reported positive experiences. The overall impact of the TA was evaluated through quantitative assessment of the client's experience and qualitative analysis of interviews. Collectively, this research demonstrates the feasibility of conducting a TA virtually, in an efficacious manner, that leads to positive client outcomes.