Implementing the Patient-Centered Medical Home Model for Chronic Disease Care in Small Medical Practices

Baxter, Louisa; Nash, David B.

doi:10.1177/1062860612454451

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Previous literature suggests that PCPs have varying views of barriers and resources needed to implement the medical home. 13 On one hand, this study is encouraging that some aspects of organizational climate seem to be associated with successful implementation of the medical home. These results make intuitive sense and support the notion of high-functioning organizations.…”

Section: Discussionmentioning

confidence: 68%

The Effect of Organizational Climate on Patient-Centered Medical Home Implementation

et al. 2014

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Organizational climate is a key determinant of successful adoption of innovations; however, its relation to medical home implementation is unknown. This study examined the association between primary care providers' (PCPs') perception of organization climate and medical home implementation in the Veterans Health Administration. Multivariate regression was used to test the hypothesis that organizational climate predicts medical home implementation. This analysis of 191 PCPs found that higher scores in 2 domains of organizational climate (communication and cooperation, and orientation to quality improvement) were associated with a statistically significantly higher percentage (from 7 to 10 percentage points) of PCPs implementing structural changes to support the medical home model. In addition, some aspects of a better organizational climate were associated with improved organizational processes of care, including a higher percentage of patients contacted within 2 days of hospital discharge (by 2 to 3 percentage points) and appointments made within 3 days of a patient request (by 2 percentage points).

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Section: Discussionmentioning

confidence: 68%

The Effect of Organizational Climate on Patient-Centered Medical Home Implementation

et al. 2014

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“…Directed content analysis starts with a framework that directs the analysis. In this study, research questions were guided by the patient-centered medical home model (PCMH) [ 33 , 34 , 35 ], a community-based care system model that aims to provide comprehensive and accessible patient-centered care for persons with HIV [ 36 , 37 , 38 , 39 , 40 ].…”

Section: Methodsmentioning

confidence: 99%

Patients, Social Workers, and Pharmacists’ Perceptions of Barriers to Providing HIV Care in Community Pharmacies in the United States

2021

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Retaining people living with HIV (PLWH) in clinical care is a global priority to end the HIV epidemic. Community pharmacies in the United States have structural influences on the success or failure of retention in HIV care by supporting patients’ complex needs. However, to date, barriers to retention in care in the community pharmacy setting have not been examined beyond pharmacy services of medication therapy management. We utilized the patient-centered medical home model to examine the barriers to HIV care in the community pharmacy setting. We utilized semi-structured interviews to collect data from 15 participants: five PLWH, five community pharmacists, and five social workers from a midwestern state. Interview data were transcribed and analyzed using directed content analysis. Four key themes emerged regarding the barriers that impact utilization of community pharmacy services by PLWH: the perception of the role of community pharmacists in HIV care, perceptions of pharmacists’ HIV knowledge, perceptions of pharmacy operation and services, and negative experiences within the community pharmacy space. Participants’ perceptions of solutions for improving HIV care in the community pharmacy focused on improving the relationship between pharmacists and patients, ensuring that the community pharmacy is a private and safe space for patients, and having a diverse pharmacy staff that is equipped to take care of the diverse and marginalized HIV population, such as transgender people.

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“…At the same time, without the full acceptance and buy-in of physician leadership, the PCMH may not be fully implemented or sustained (Baxter & Nash, 2013;Nutting et al, 2009). One way to move support physician leadership might be via peer-to-peer physician coaching (Nutting et al, 2009;Sekerka & Chao, 2003).…”

Section: Opportunities For Social Workers In the Pcmhmentioning

confidence: 96%

“…Fully-integrated EHRs are essential to the success of the PCMH and CCI (Baxter & Nash, 2013). Technical assistance for practices still struggling with the transition from paper would be beneficial, as would additional support for the costs of operating and not just purchasing EHRs.…”

Section: Opportunities For Social Workers In the Pcmhmentioning

confidence: 98%

Opportunities for Social Workers in the Patient Centered Medical Home

Hawk

Ricci

Huber

et al. 2014

Social Work in Public Health

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The Patient Centered Medical Home (PCMH) has been hailed as one method of improving chronic care outcomes in the United States. A number of studies have underscored the importance of the social work role within the PCMH, yet little existing research explores the social worker as a driver of improved patient care. The Pennsylvania Chronic Care Initiative was created with a primary goal of increasing the number of practices that were recognized as PCMH by the National Committee for Quality Assurance. This article describes findings from in-depth qualitative interviews with representatives from seven primary care practices, in which the authors examined barriers and facilitators to implementation of the initiative. Barriers to implementation included small practice size, payer-driven care, not having a strong physician champion, variability within patient populations, and high implementation costs. Facilitators included having a social worker coordinate behavioral health services, clinical nurse case managers, preexisting models of outcomes-driven care, and being part of an integrated health delivery and financing system. Recommendations strengthening the role of medical social workers in primary care practices are discussed.

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Implementing the Patient-Centered Medical Home Model for Chronic Disease Care in Small Medical Practices

Cited by 7 publications

References 9 publications

The Effect of Organizational Climate on Patient-Centered Medical Home Implementation

The Effect of Organizational Climate on Patient-Centered Medical Home Implementation

Patients, Social Workers, and Pharmacists’ Perceptions of Barriers to Providing HIV Care in Community Pharmacies in the United States

Opportunities for Social Workers in the Patient Centered Medical Home

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