Continuing education (CE) is crucial to improving clinician knowledge and confidence. Our team at The France Foundation (TFF) designs education to reinforce sustainable improvements for complex care environments, especially those serving vulnerable populations, informing current clinical practices, and integrating into existing systems of care seamlessly.

In the last year, TFF implemented a learning collaborative model that intentionally combined CE with quality improvement (QI) methodology. The result was a program that moved beyond traditional education, supporting measurable changes in clinical workflows, team collaboration, and patient engagement. 

Addressing the CE–QI Gap

Health care teams, particularly in community-based settings like Federally Qualified Health Centers (FQHCs), face persistent challenges: fragmented workflows, evolving team structures, competing priorities, limited time and resources for patient education, and barriers to implementing new clinical processes, to name a few. While CE providers are well-positioned to influence outcomes, access to these systems and the ability to support implementation can be limited. Traditional CE models, delivered as one-time educational interventions, often fall short in driving sustained improvement. This program was designed to address that gap. 

A Model Built for Real-World Practice Change

The initiative integrated a dual approach to ensure education was aligned with implementation strategies and outcomes measurement from the beginning. One core component was a Learning Collaborative, which provided system-level QI coaching, process evaluation, and change management support. 

Participating clinics engaged in structured activities, including process mapping to uncover workflow gaps, root cause analysis to identify systemic barriers, iterative Plan-Do-Study-Act (PDSA) cycles, and data-driven decision making using HRSA measures. These tools enabled teams to move from assumption to insight, revealing opportunities for improvement that were not always visible in day-to-day operations. 

“We know the process, or sometimes we think we know the process, but once you put it down and step by step you actually start discovering new things like, oh I didn’t realize we did this …” 

Across participating sites, all cohorts experienced significant competence gains. Teams with greater initial awareness of systemic complexity showed even stronger post-program improvements. Overall, improvements in both clinician confidence and competence following the program led to increased readiness to address clinical practice gaps.  

From Insight to System-Level Change

Beyond individual learning, the program drove tangible changes at the system and workflow level: 

• Establishment of multidisciplinary care teams  

• Implementation of standardized workflows and referral processes  

• Increased coordination across providers, including behavioral health, nutrition, and pharmacologic care  

• Improved communication through structured team meetings and shared processes  

Participants reported greater alignment across care teams and more consistent engagement in quality improvement efforts. 

“I’ve seen more consistency and involvement with those who are sharing more information and becoming more involved.” 

These findings showcase that, when education is paired with QI methodology and coaching, even teams facing significant barriers can improve processes, team communication, and documentation of clinical measures to improve patient outcomes.  

While long-term outcomes will continue to evolve, early indicators of patient impact were encouraging. Reports of increased patient engagement in structured care programs and adherence to follow-up and treatment plans were recorded. Behavioral, emotional, and clinical factors were integrated into care discussions. Clinicians also began to adopt more holistic approaches, incorporating motivational interviewing and addressing social determinants of health as part of routine care. 

One of the most compelling outcomes of the initiative was its scalability. Following the pilot phase: 

• Participating FQHCs initiated scalability plans to expand beyond the original 11 pilot clinics to an average of 72% of clinic sites (37 of 51 possible clinic sites)  

• Over 21,500 additional patients were diagnosed with overweight or obesity, reflecting improved processes for screening and documentation  

These results demonstrate how a targeted educational intervention, when paired with QI methodology, can extend its impact far beyond the initial learning cohort. 

Rethinking What Education Can Achieve 

This program underscores a broader shift in continuing education from one-time activities to longitudinal engagement. Individual learners may make up the systems of care, but the systems must be structured in a way to support those individual learners. Measuring participation and knowledge isn’t the only way to go: measuring  practice transformation and patient impact, while challenging and time-intensive, helps to drive lasting, positive performance change. 

As health care systems continue to evolve, the need for education that supports real-world outcomes will only grow. Programs that integrate CE with QI methodologies offer a promising path forward, one that bridges the gap between learning and doing. Our team remains focused on designing education that does just that, empowering clinicians and care teams to improve clinical practices and patient outcomes. 

Reach out to TFF below to discover how we can help your program achieve the same.