Evaluation of patient centered medical home practice transformation initiatives

Benjamin F. Crabtree, Sabrina M. Chase, Christopher G. Wise, Gordon D. Schiff, Laura A. Schmidt, Jeanette R. Goyzueta, Rebecca A. Malouin, Susan M.C. Payne, Michael T. Quinn, Paul A. Nutting, William L. Miller, Carlos Roberto Jaén

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)10-16
Number of pages7
JournalMedical Care
Volume49
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • PCMH
  • evaluation
  • implementation
  • patient-centered medical home
  • primary care practice redesign
  • qualitative methods
  • quality improvement

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Fingerprint Dive into the research topics of 'Evaluation of patient centered medical home practice transformation initiatives'. Together they form a unique fingerprint.

Cite this