First Things First: Foundational Requirements for a Medical Home in an Academic Medical Center

Patient‐Centered Medical Home Implementation and Improved Chronic Disease Quality: A Longitudinal Observational Study

“…PACT implementation often proceeded in a step‐wise fashion (Forman et al. ), with clinics first focusing on hiring and training new staff and creating new teamlet structures, then on implementing new PACT processes (such as new scheduling systems or teamlet huddles), and only then did many clinics start to apply new PACT processes toward quality improvement in chronic disease care. Therefore, it can take months to years to work through these steps carefully to the point where PCMH is implemented to the extent that it can start to affect even clinical processes (such as checking HbA1c regularly).…”

“…Furthermore, implementing a large multifaceted program such as PACT can consume much of the energy and resources of local leaders and staff (Forman et al. ); in some clinics still in earlier implementation phases, this could inadvertently draw attention away from chronic disease quality improvement goals during initial PACT startup.…”

The Veterans Affairs Patient Aligned Care Team (VA PACT), a New Benchmark for Patient-Centered Medical Home Models: A Review and Discussion

“…During the beginning stages of strategic planning for implementing VA's PACT, top challenges faced by primary care directors were reviewed and included clinical informatics, chronic pain management, and care coordination [54]. In the early stages of implementation, several challenges were identified to move to the team-based approach including: (1) short-staffing undermined development of team-based working relationships; (2) lack of co-location of PACT members in clinic and difficulty communicating with residents when they were off-site hampered communication and; (3) limited clinic hours of part-time primary care providers and residents prevented clinicians to get the training and reinforcement of PCMH principles which delayed the team formation [55].…”

Do medical residents perform patient-centered medical home tasks? A mixed-methods study

“…Recognizing that working in a PCMH does not necessarily equate with understanding PCMH goals and priorities, PCMH curricula for residents have been developed [10–12]. Several studies have described both faculty and resident knowledge and attitudes towards PCMH principles, as well as barriers to delivering patient-centered care in a training environment [13,14]. The performance of individual components of patient-centered care, including team-based care, group visits, and quality improvement, has been studied [15–18].…”