Document Detail


Implementing the patient-centered medical home: observation and description of the national demonstration project.
MedLine Citation:
PMID:  20530392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Elizabeth E Stewart; Paul A Nutting; Benjamin F Crabtree; Kurt C Stange; William L Miller; Carlos Roberto Jaén
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of family medicine     Volume:  8 Suppl 1     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-10-07     Revised Date:  2011-02-10    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S21-32; S92     Citation Subset:  IM    
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
Family Practice / 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:
K05 CA140237-01/CA/NCI NIH HHS
Comments/Corrections
Erratum In:
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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