The Patient-Centered Medical Home

Rittenhouse, Diane R.; Shortell, Stephen M.

doi:10.1001/jama.2009.691

Cited by 308 publications

(82 citation statements)

References 9 publications

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“…9,10,12 Emergent themes in our study parallel many of the cultural and structural tenets of the patient-centered medical home, including creating multidisciplinary teams, promoting interdisciplinary communication, working to the "top of the license," tailoring care to the needs of each patient, and working for payment reform. 29,30 Results also support the need for process standardization. As suggested by participants and as adopted by some broad scale redesign efforts, this could include standard discharge checklists and crosssite coordination.…”

Section: Discussionmentioning

confidence: 73%

“Did I Do as Best as the System Would Let Me?” Healthcare Professional Views on Hospital to Home Care Transitions

et al. 2012

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Section: Discussionmentioning

confidence: 73%

“Did I Do as Best as the System Would Let Me?” Healthcare Professional Views on Hospital to Home Care Transitions

et al. 2012

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“…A PCN is akin to the "medical home." 18 The four PCNs represented 140 family physicians and 180,000 patients, with an estimated 10,000 patients with Type 2 diabetes. Eligible patients were aged Z18 years, had Type 2 diabetes, and screened positive for depressive symptoms based on Patient Health Questionnaire (PHQ) scores Z10.…”

Section: Setting and Populationmentioning

confidence: 99%

Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care

Johnson

Lier

Soprovich

et al. 2016

American Journal of Preventive Medicine

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“…The two patient experience measures, created using specific patient survey questions, were included because they underscore the importance of patient-centered care. 16 …”

Section: Physician Samplementioning

confidence: 99%

Setting a Fair Performance Standard for Physicians’ Quality of Patient Care

et al. 2010

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BACKGROUND: Assessing physicians' clinical performance using statistically sound, evidence-based measures is challenging. Little research has focused on methodological approaches to setting performance standards to which physicians are being held accountable. OBJECTIVE: Determine if a rigorous approach for setting an objective, credible standard of minimally-acceptable performance could be used for practicing physicians caring for diabetic patients. DESIGN: Retrospective cohort study. PARTICIPANTS: Nine hundred and fifty-seven physicians from the United States with time-limited certification in internal medicine or a subspecialty. MAIN MEASURES: The ABIM Diabetes Practice Improvement Module was used to collect data on ten clinical and two patient experience measures. A panel of eight internists/subspecialists representing essential perspectives of clinical practice applied an adaptation of the Angoff method to judge how physicians who provide minimallyacceptable care would perform on individual measures to establish performance thresholds. Panelists then rated each measure's relative importance and the Dunn-Rankin method was applied to establish scoring weights for the composite measure. Physician characteristics were used to support the standard-setting outcome. KEY RESULTS: Physicians abstracted 20,131 patient charts and 18,974 patient surveys were completed. The panel established reasonable performance thresholds and importance weights, yielding a standard of 48.51 (out of 100 possible points) on the composite measure with high classification accuracy (0.98). The 38 (4%) outlier physicians who did not meet the standard had lower ratings of overall clinical competence and professional behavior/attitude from former residency program directors (p=0.01 and p=0.006, respectively), lower Internal Medicine certification and maintenance of certification examination scores (p= 0.005 and p< 0.001, respectively), and primarily worked as solo practitioners (p=0.02). CONCLUSIONS: The standard-setting method yielded a credible, defensible performance standard for diabetes care based on informed judgment that resulted in a reasonable, reproducible outcome. Our method represents one approach to identifying outlier physicians for intervention to protect patients.

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The Patient-Centered Medical Home

Cited by 308 publications

References 9 publications

“Did I Do as Best as the System Would Let Me?” Healthcare Professional Views on Hospital to Home Care Transitions

“Did I Do as Best as the System Would Let Me?” Healthcare Professional Views on Hospital to Home Care Transitions

Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care

Setting a Fair Performance Standard for Physicians’ Quality of Patient Care

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