Table 3 Next steps to accelerate the pace of the roll-out of the PHARE-M in France

1 Develop the French CF Registry

 - Reduce the time taken to produce annual Registry reports;

 - Achieve public transparency of the results by center;

 - Advance towards an encounter-based national CF database which produces annual Registry reports as well as ongoing (quarterly) results for the monitoring of the QIPs at the centers

2 Strengthen the motivation of the teams to enroll in PHARE-M program

 - Report the PHARE-M experience, results and satisfaction during professional conferences and patient organization assemblies;

 - Get the CF community leadership, professionals and the patient organization more involved in continuous quality improvement;

 - Continue to obtain funding from the patient organization for the extra-time needed for the PHARE-M referent at each center during the training year;

 - Validate continuing professional development credits through the PHARE-M;

 - Maintain a focus on continuous quality improvement with financial support for post-PHARE-M cycles until other funding is available (see below);

 - Develop a convergence between the roll-out of the PHARE-M and other actions to increase the availability of professional resources, access to CF care guidelines translated in French, and tutoring by discipline within the network;

3 Consolidate and develop expertise and resources for the PHARE-M

 - Organize a community of PHARE-M referents from the centers for advanced training on measurement, effective meeting skills, quality tools (fishbone diagrams, PDSAs, patient shadowing);

 - Develop a culture of publishing QI initiatives according to SQUIRE standards

 - Improve and adapt the PHARE-M website to show the various aspects of the program (registration to the CPD program, international research, international community ties, publications, etc.…)

4 Build alliances at the hospital and national health system levels

 - Continue contributing to the hospital certification process, supporting the hospital quality department through improvement actions, Professional Practice Evaluations, or hospital quality indicators;

 - Develop new CPD programs for post PHARE-M cycles focusing on providing reminders of the QI method and tools, benchmarking, measuring and writing for publications;

 - Participate in conferences of health authorities or working groups aimed at care quality improvement and patient involvement in healthcare to promote this QI LLC method;