Turning on the Care Coordination Switch in Rural Primary Care

Fagnan, Lyle J.; Dorr, David A.; Davis, Melinda M.; McGinnis, Paul; Mahler, Jo; King, Molly M.; Michaels, LeAnn

doi:10.1097/jac.0b013e31821c63ee

Cited by 14 publications

(4 citation statements)

References 19 publications

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“…In contrast to physicians who perceived consistent daily availability of PCPs as unnecessary to affect patient outcomes, clinic efficiency, and care coordination, practice sites that lack consistent daily PCP presence perceived on-site daily availability of PCPs as a necessity for care coordination and patient follow-up. This may be attributable to individual patient scenarios where the clinical expertise of PCPs is considered imperative to make treatment decisions (Fagnan et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area

Wan

Teichman²,

Latif

et al. 2017

Journal of Interprofessional Care

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To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers' beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available each day were perceived as better able to coordinate care and follow up with patients (p = .031), while teams that included clinical pharmacists were perceived as preventing medication-associated problems (p < .0001). Healthcare providers perceived the interprofessional care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.

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Section: Discussionmentioning

confidence: 99%

Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area

Wan

Teichman²,

Latif

et al. 2017

Journal of Interprofessional Care

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“…In national studies, it is rarely feasible to send research coordinators or facilitators to each of the study sites on a repeated basis. 57 , 76 Therefore, the study must be designed in a manner that allows the study personnel to carry out the study with limited use of practice resources. This difference is highlighted in the sections on study and intervention implementation.…”

Section: Discussionmentioning

confidence: 99%

Protocol for the asthma tools study: a pragmatic practice-based research network trial

Yawn¹,

Bertram²,

Kurland³

et al. 2013

POR

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BackgroundAsthma is common among children, adolescents, and adults. However, management of asthma often fails to follow evidence-based guidelines. Control assessments have been developed, validated against expert opinion, and disseminated. However, in primary care, assessment of control is only one step in asthma management. To facilitate integration of the evidence-based guidelines into practice, tools should also guide the next steps in care. The Asthma APGAR tools do just that, incorporating a control assessment as well as assessment of the most common reasons for inadequate and poor control. The Asthma APGAR tool is also linked to a care algorithm based on the 2007 National Heart, Lung, and Blood Institute asthma guidelines. The objective of this study is to assess the impact of implementation of the Asthma APGAR on patient asthma outcomes in primary care practices.MethodsA total of 1400 patients aged 5–60 years with physician-diagnosed asthma are enrolled in 20 practice-based research network (PBRN) practices randomized to intervention or usual care. The primary outcomes are changes in patient self-reported asthma control, asthma-related quality of life, and rates of exacerbations documented in medical records over the 18–24 months of enrollment. Process measures related to implementation of the Asthma APGAR system into daily care will also be assessed using review of medical records. Qualitative assessments will be used to explore barriers to and facilitators for integrating the Asthma APGAR tools into daily practice in primary care.DiscussionData from this pivotal pragmatic study are intended to demonstrate the importance of linking assessment of asthma and management tools to improve asthma-related patient outcomes. The study is an effectiveness trial done in real-world PBRN practices using patient-oriented outcome measures, making it generalizable to the largest possible group of asthma care providers and primary care clinics.

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“…Many PCMH demonstration projects are instituting care coordinators within primary care practices to help eliminate gaps in shared information and communication among providers and between patients and providers (Patient-Centered Primary Care Collaborative, 2009). However, there is limited research documenting care coordination processes and coordinators’ experiences from their own perspectives (Fagnan et al, 2011; Ferrante, Cohen, & Crosson, 2010; Henderson, Princell, & Martin, 2012). Furthermore, the role of care coordinator is relatively new in primary care settings, and how this role manifests and is integrated into the practice is unknown.…”

Section: Planning and Developmentmentioning

confidence: 99%

Lessons Learned Designing and Using an Online Discussion Forum for Care Coordinators in Primary Care

et al. 2016

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While an increasing number of researchers are using online discussion forums for qualitative research, few authors have documented their experiences and lessons learned to demonstrate this method's viability and validity in health services research. We comprehensively describe our experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. Our lessons learned from each phase, including planning, designing, implementing, using, and ending this private online discussion forum, provide some recommendations for other health services researchers considering this method. An asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.

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Turning on the Care Coordination Switch in Rural Primary Care

Cited by 14 publications

References 19 publications

Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area

Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area

Protocol for the asthma tools study: a pragmatic practice-based research network trial

Lessons Learned Designing and Using an Online Discussion Forum for Care Coordinators in Primary Care

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