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Medical Society of Virginia Foundation

"We have found an innovative way of diffusing the guidelines into primary care and been successful in changing practice patterns."

Helen Ragazzi, M.D., Pediatric Medical Director, Medical Society of Virginia Foundation (Richmond, VA)

Project Snapshot

Physician and nursing staff participating in MSVF's IMPACT Pediatrics project.
Physician and nursing staff participating in MSVF's IMPACT Pediatrics project.

The Medical Society of Virginia Foundation's (MSVF) Improving Asthma Care and Treatment (IMPACT™) used clinical training and practice redesign—with the incentive of Part IV Maintenance of Certification credit awarded by the American Board of Family Medicine, a partner in MSVF's NACI Demonstration Project—to take seven primary care practice teams in Virginia through a quality improvement initiative to improve their delivery of guidelines-based asthma care. MSVF previously guided five practices through a similar interactive process under its NACI Demonstration Project.

MSVF trained the six IMPACT™-enrolled primary care practice teams on the National Asthma Education and Prevention Program's (NAEPP) Expert Panel Report 3—Guidelines for the Diagnosis and Management of Asthma (EPR-3) and its six priority messages from the Guidelines Implementation Panel (GIP) Report and on how to put the skills and knowledge they acquired into clinical practice. After selecting their specific quality improvement aims, the six teams tested practice changes using Plan-Do-Study-Act (PDSA) cycles, shared information gathered from their PDSA cycles and regular chart reviews, and received feedback and mentoring from IMPACT™ and its network of asthma and quality improvement experts.

Project Goal

Enable physician teams to put the key GIP Report messages of the NAEPP's EPR-3 guidelines into practice so that patients will have better asthma control and improved quality of life.

Challenges & Solutions

Challenge: Recruit practices. Physicians and their staff were very busy, and it was difficult at first to find practices willing to invest time in the program.

Solution: Individualize recruitment and collaborate. To reach a larger pool of physician practices, MSVF partnered with the Virginia Chapter of the American Academy of Pediatrics as well as Sentara and Bon Secours Health Systems. Moreover, for teams whose lead physicians were unable to attend the initial training, MSVF followed up with each team to review the training materials and program requirements.


MSVF highlighted a different GIP message in its bi-weekly updates to practice teams.

MSVF conducted a topic-specific conference call twice each month to optimize participation for physicians and nurses on the practice teams.

MSVF set up an Extranet site that facilitated information-sharing among the practice teams and enabled individual physicians to keep track of their progress on quality improvement measures.


MSVF shared and collaborated with other NACI-funded projects to improve asthma care and control. For example:

MSVF partnered with another NACI Clinical Champion project, the University of Washington, which offered spirometry training resources to teams enrolled in IMPACT™. As a result, the University of Washington committed to conduct spirometry training with five sites in collaboration with MSVF. The EPR-3 recommends that office-based physicians who care for patients with asthma have access to spirometry, the preferred method for measuring lung function to diagnose asthma, assess asthma severity, and monitor asthma control.

To meet its project goals, MSVF used clinician training and focused on practice redesign.

Other NACI-funded projects that used MSVF-type approaches are:

Medical Society of Virginia Foundationexternal disclaimer
2924 Emerywood Parkway, Suite 300
Richmond, VA 23294—3746

Last Updated January 2013