Making publicly subsidized funding of primary care contingent on clinical outcomes for practice populations may be required to incentivize adoption of different clinical activities.
Tangible outcomes for practice are a key component of the model and, as proposed earlier, clear methods for identifying and measuring these should be stipulated at the outset.
When the range of strategic drivers for research at individual and organizational levels are identified and understood at the outset, the partners will be more able to provide a realistic context for identifying achievable, measurable outcomes for practice.
The PARTNER Study tested this hypothesis in a randomized controlled trial (RCT) comparing outcomes for practices with access to the 12-month telephone coaching intervention for their patients to those from practices who provide usual care.
However, some rupture of internal practice goodwill has been documented with the sense that nurses are working hard to produce quality outcomes for the practice which financially benefit GPs, but where the bulk of the burden in achieving these is borne by nursing staff [ 20].
An audit requires the use of an audit tool, the collection and analysis of actual performance in relation to best evidence or practice, and finally the identification of an outcome(s) for practice [ 4].
As Mitchell and Sullivan [ 15] stated in their recent review, we should accept that the computer is a useful tool and start trying to evaluate key outcomes for patients, practices and the health service as a whole.
He discusses how multilogical methodology, polysemia, subjectivity, and polyphonia can be employed to preserve the integrity and potential of knowledge systems that can help to generate and maintain disparate perspectives, outcomes, and implications for practice.
In contrast to the mainstream of research in science education, I advocate a multilogical methodology that embraces incommensurability, polysemia, subjectivity, and polyphonia as a means of preserving the integrity and potential of knowledge systems to generate and maintain disparate perspectives, outcomes, and implications for practice.
Early identification of the proposed outcomes and impact for practice of the collaborative activity is the final overarching factor in the model.
When measurable outcomes and impacts for practice are specified at the outset and linked to the strategic aims of the partner organizations, progress towards achieving the goals of an integrated collaboration will be greater than if the strategic link does not exist.
