• Paula Darby Lipman and Cheryl B Aspy.
• From Westat, Rockville, MD (PDL); and the Department of Family & Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City (CBA). paulalipman@westat.com.
• J Am Board Fam Med. 2016 Sep 1; 29 (5): 543-52.

BackgroundFour practice-based research networks (PBRNs) participated in a project to increase the diffusion of evidence-based treatment guidelines for chronic kidney disease (CKD). A multicomponent organizational intervention engaged regionally proximal primary care practices in a series of facilitated meetings, referred to as local learning collaboratives (LLCs).MethodsThe 2-wave strategy began with 8 practices in each PBRN receiving practice facilitation and subsequently joining an LLC. A sequential mixed-methods design addressed the conduct, content, and fidelity of the intervention; clinicians in 2 PBRNs participated in interviews, and PBRN coordinators reflected on implementation challenges.ResultsLLCs were formed in 3 PBRNs, with 121 monthly meetings held across 20 LLCs. Slightly more than half of the participants were clinicians. Qualitative data suggest that clinicians increased the priority for CKD care, improved knowledge and skills, were satisfied with the project, and attempted to improve care. Implementation challenges were encountered and concerns about sustainability expressed.ConclusionWhile PBRNs can successfully leverage resources to diffuse treatment guidelines, and LLCs are well-accepted by clinical staff, the formation of LLCs was not feasible for 1 PBRN, and others struggled to meet regularly and have performance data available despite logistic support.© Copyright 2016 by the American Board of Family Medicine.

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