How Do Innovative Primary Care Practices Achieve the Quadruple Aim?

Wagner, Edward H.; LeRoy, Lisa; Schaefer, Judith; Bailit, Michael H.; Coleman, Katie; Zhan, Chunliu; Meyers, David

doi:10.1097/jac.0000000000000249

Cited by 13 publications

(14 citation statements)

References 31 publications

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“…Referrals to IPC team members are primarily through physicians, and the COVID-19 response has highlighted the need for reconsideration of this traditional referral model to improve access to the range of services embedded within interprofessional models of primary care. The literature has identified referral processes as a critical component of supporting access to and fostering integrated primary care [ 23 , 24 ]. Moving forward teams need to consider how patients can have direct access to team members to best support patients managing the direct and indirect consequences of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Interprofessional primary care during COVID-19: a survey of the provider perspective

et al. 2021

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Background Interprofessional primary care (IPC) teams provide comprehensive and coordinated care and are ideally equipped to support those populations most at risk of adverse health outcomes during the COVID-19 pandemic, including older adults, and patients with chronic physical and mental health conditions. There has been little focus on the experiences of healthcare teams and no studies have examined IPC practice during the early phase of the COVID-19 pandemic. The objective of the study was to describe the state of interprofessional health provider practice within IPC teams during the COVID-19 pandemic. Methods Observational cross-sectional design. A web-based survey was deployed to IPC providers working in team-based primary care clinics in the province of Ontario, Canada. The survey included 26 close-ended and six open-ended questions. Close-ended questions were analyzed using descriptive statistics. Content analysis was used to analyze the open-ended questions. Results 445 surveys were included in the final analysis. Service delivery shifted from in-person care (77% pre-COVID-19) to telephone (76.5% during the COVID-19 pandemic). Less than half of the respondents (40%) reported receiving any training for virtual delivery. Wait times to access team members were reported to have decreased. There has also been a shift in what IPC providers report as the most commonly seen conditions, with increases in visits related to mental health concerns, acute infections (including COVID-19), social isolation, and resource navigation. Respondents also reported a reduction in healthcare provision for multiple chronic conditions including diabetes, cardiovascular disease, and chronic pain. Conclusions IPC teams are rapidly shifting their practice to supporting their patients during the pandemic. A surge in mental health issues has been seen and is expected to continue to increase in response to COVID-19. Understanding early experiences can help plan for future pandemic waves.

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Section: Discussionmentioning

confidence: 99%

Interprofessional primary care during COVID-19: a survey of the provider perspective

et al. 2021

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“…This is the first of a series of studies that is using complex intervention development methods to design a model of primary care for acute LBP, called My Back My Plan . The model of care is being designed to align with a contemporary model of health care known as the Quadruple Aim, 23 which aims to meet consumers' needs with person-centred care, address clinicians' work life, improve population health, and reduce costs with high-value care. This survey contributes to the first aim of meeting consumers' needs.…”

Section: Discussionmentioning

confidence: 99%

The experiences and needs of people seeking primary care for low-back pain in Australia

Ahern

Dean

Dear

et al. 2019

PR9

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“…The delivery of the intervention will be supported by a well-developed infrastructure that will enable the clinic to make needed system improvements and deliver high-quality patient-centred care. Key elements of the infrastructure are consistent with key features of integrated care for older adults and high-performing primary care practices, 21,76 These include (i) engaged leadership that understands and visibly supports changes in practice, (ii) use of a person-centred approach to care, (iii) use of team-based care, (iv) expanded responsibilities of staff, (v) training and support for providers implementing the intervention, (vi) the addition of an RN and a SW to the usual outpatient rehabilitation team of providers (OT, PT and SLP), (vii) change in workflows and systems, and (viii) use of MyST to support communication and coordination of care among the IP team.…”

Section: Methodsmentioning

confidence: 91%

Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol

et al. 2019

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Background:Stroke is a major life-altering event and the leading cause of death and disability in Canada. Most older adults who have suffered a stroke will return home and require ongoing rehabilitation in the community. Transitioning from hospital to home is reportedly very stressful and challenging, particularly if stroke survivors have multiple chronic conditions. New interventions are needed to improve the quality of transitions from hospital to home for this vulnerable population.Objectives:The primary objective of this study is to examine the feasibility of implementing a new 6-month transitional care intervention supported by a web-based app. The secondary objective is to explore its preliminary effects.Design:A single arm, pre/post, pragmatic feasibility study of 20–40 participants in Ontario, Canada. Participants will be community-dwelling older adults (≥55 years) with a confirmed stroke diagnosis, ≥2 co-morbid conditions, and referred to a hospital-based outpatient stroke rehabilitation centre. The 6-month transitional care intervention will be delivered by an interprofessional (IP) team and involve care coordination/system navigation, self-management education and support, home visits, telephone contacts, IP team meetings and a web-based app. Primary evaluation of the intervention will be based on feasibility outcomes (e.g. acceptability, fidelity). Preliminary intervention effects will be based on 6-month changes in health outcomes, patient experience, provider experience and cost.Conclusions:Information on the feasibility and preliminary effects of this newly-developed intervention will be used to optimize the design and methods for a future pragmatic trial to test the effectiveness and implementation of the intervention in other contexts and settings.

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How Do Innovative Primary Care Practices Achieve the Quadruple Aim?

Cited by 13 publications

References 31 publications

Interprofessional primary care during COVID-19: a survey of the provider perspective

Interprofessional primary care during COVID-19: a survey of the provider perspective

The experiences and needs of people seeking primary care for low-back pain in Australia

Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol

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