Table 2.

Thematic Summary of PBRN Clinician Motivation Emphasizing IMPROVING LOCAL CLINIC-BASED CARE

Primary Theme: Implementing health information technology
Main types of satisfaction	Quote
Improve quality of care	(re: patient safety—evaluation of office errors) “The `near misses' reports generated by the practice not only encouraged the physicians, but also the office staff to understand the importance of patient safety.”

Primary Theme: Answering primary care questions of most importance to practicing clinicians
Main types of satisfaction	Quote
Improve quality of care	“The only valid reason to do applied research is to improve quality. Therefore research and quality improvement are so closely linked that it usually makes no sense to distinguish them one from the other. Research is not a goal (as in “We have to do more research.”); it is a set of tools that can often be used to overcome the obstacles encountered when trying to achieve goals.”

Primary Theme: Participation in PBRN increases the relevance of research for local clinic population/vulnerable population not often part of research studies (rural migrant community)
Main types of satisfaction	Quote
Increased relevance of research to clinic/community	It (the research network) has the great advantage of potentially having an impact on my own patients by seeing their problems and eventually finding a different more effective way to deal with them.”

Primary Theme: Information to improve practice operations and quality improvement / Listserv to ask questions
Main types of satisfaction	Quote
Improved clinical care	“The network provides me with an experienced panel to answer all kinds of questions that may occur: things as simple as how to code a procedure to clinical questions that are answered via the listserv.”

Primary Theme: Connecting with the academic health center through the use of PBRN practice enhancement assistants
Main types of satisfaction	Quote
Make practice-based research possible	“The Practice Enhancement Assistant (PEA) is able to take the oftentimes complex and difficult to understand research protocols and make a simpler understanding for each person's part in the protocol.” “Practice Enhancement Assistants (PEAs) often help practices with both office procedures and preparing or finding good patient education materials.”

Primary Theme: Provided safe environment to explore patient safety and quality improvement (in this case, patient safety and increasing immunization rates)
Main types of satisfaction	Quote
Improved quality of care/patient safety	“Many things we fear as clinicians, such as insurance companies looking at prescribing habits, make us hesitate to participate…but the research network wants to work with us to improve quality of care -- people we seek out and want to be involved with.”

Primary Theme: Improving the delivery of chronic illness care and population-based medicine / implementing a disease registry / training in Plan-Do-Study-Act (PDSA) cycles
Main types of satisfaction	Quote
Improved clinical care and quality improvement	“When measured against our contemporaries we continually rise to the top because we chose to participate in this (QI) project. We frequently outperform the large systems with expensive electronic medical records because we participated in this diabetes project. We have expanded our measurements to coronary artery disease, hypertension, depression and asthma. We see the value in measuring and actively managing disease processes to provide world-class care to our patients. Had we not participated in this study I wonder if we would be five years behind in assessing and improving the quality of care that we provide to our patients.” “The network has allowed me to have a better practice and be better at disease management.” [The network's practice enhancement assistant implemented a diabetes registry and trained the practice in PDSA cycles.]

Primary Theme: Practice innovation/redesign / able to feel positive about Family Medicine at a time when American medicine is abandoning it
Main types of satisfaction	Quote
Quarterly performance reviewing/Turning Research Into Practice (TRIP) study led to improved quality of care	“We would not have made these (care-related) changes without the supportive environment of the research network. We were able to stand back and examine our practice in a manner otherwise impossible. We are then able to modify our behavior and improve our practice performance.