The objective of this study was to describe the experience of a Quality Improvement Organization (QIO) providing educational outreach to promote use of quality improvement (QI) tools in primary care private practice. Two QIO outreach workers conducted visits with physicians and targeted staff. Data were analyzed on physician demographics, visits, and use of QI tools using standard quantitative and qualitative methods. QIO staff frequently encountered difficulty in accessing physicians and administrative staff and reported many barriers to QI. Despite these challenges, outreach visits were associated with adoption of QI tools, and certain physician characteristics were associated with greater numbers of outreach visits and tools adopted. QIOs and other external parties who seek to improve quality of care in private practice primary care physician offices face challenges in gaining access to physicians and administrative personnel. Additional study is needed to better understand associations between physician characteristics, educational outreach visits, and adoption of QI tools.