| Implementing the patient-centered medical home: observation and description of the national demonstration project. | |
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MedLine Citation:
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PMID: 20530392 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. METHODS: An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). RESULTS: The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. CONCLUSIONS: The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning. |
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Authors:
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Elizabeth E Stewart; Paul A Nutting; Benjamin F Crabtree; Kurt C Stange; William L Miller; Carlos Roberto Jaén |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of family medicine Volume: 8 Suppl 1 ISSN: 1544-1717 ISO Abbreviation: Ann Fam Med Publication Date: 2010 |
Date Detail:
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Created Date: 2010-06-09 Completed Date: 2010-10-07 Revised Date: 2011-02-10 |
Medline Journal Info:
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Nlm Unique ID: 101167762 Medline TA: Ann Fam Med Country: United States |
Other Details:
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Languages: eng Pagination: S21-32; S92 Citation Subset: IM |
Affiliation:
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Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA. estewart@aafp.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Family Practice
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methods,
organization & administration*,
trends Humans Models, Organizational Organizational Innovation Patient-Centered Care / methods, organization & administration*, standards Program Development / methods* Program Evaluation / methods* Randomized Controlled Trials as Topic |
| Grant Support | |
ID/Acronym/Agency:
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K05 CA140237-01/CA/NCI NIH HHS |
| Comments/Corrections | |
Erratum In:
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Ann Fam Med. 2010 Jul-Aug;8(4):369 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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