Evaluation of Patient Centered Medical Home Practice Transformation Initiatives

Dados Bibliográficos

ID9102835
AutoresBenjamin F Crabtree (0000-0003-2292-6835, Lehigh Valley Hospital-Pocono, autor correspondente), Sabrina M Chase (University of Colorado Health, autor correspondente), Christopher G Wise (Michigan Medicine), Gordon D Schiff (0000-0002-2821-3994, Brigham and Women's Hospital), Louis A Schmidt (0000-0003-4346-7260, Lee University), Laura A Schmidt (0000-0002-6301-5280), Jeanette R Goyzueta, Jeanette Goyzueta (University of Colorado Health, autor correspondente), Rebecca A Malouin (Lehigh Valley Hospital-Pocono), Susan M C Payne, Susan Payne (0000-0001-9907-3477, Brigham and Women's Hospital), Michael T Quinn, Michael Quinn (0000-0003-3857-1573, University of California, San Francisco), Paul A Nutting (Lee University, autor correspondente), William L Miller (0000-0002-9957-1211, Lehigh Valley Hospital-Pocono), Carlos Roberto Jaén (0000-0001-5904-4719, Brigham and Women's Hospital)
Ano2011
Volume49
Fascículo1
Páginas10-16
Data de publicação2011-01-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181f80766
PMID21079525
PMCIDPMC3130251
OpenAlexW2042185773
IdiomaEN
Citações recebidas7
Referências citadas35

BACKGROUND: The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. METHODS: Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. RESULTS: A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. CONCLUSIONS: Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures

Best practice · Business · Family medicine · Focus group · Health care · Medical education · Medical home · Novelty · Primary care · Process (computing) · Process management · Psychological intervention · Qualitative research · Quality (philosophy) · Quality management · Referral · Service (business) · Chronic Disease Management Strategies · Computer Science · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Psychology