Transforming Primary Care Practice in North Carolina

改变北卡罗来纳州的初级保健实践

• 批准号: 7990204
• 负责人: KATRINA E DONAHUE
• 金额: $ 29.91万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7990204
• 关键词: Transforming; Primary; Care; Practice; North

DESCRIPTION (provided by applicant): The Patient-Centered Medical Home (PCMH) model involves complete primary care practice redesign with the ultimate goal to improve the quality of patient care and reduce cost. Detailed information on the best methods of practice transformation is needed to help the growing number of practices as they plan to go through this process. The overall objective of this study is to evaluate the adoption and process of transformational change in primary care practices belonging to the North Carolina Improving Performance in Practice program (NC IPIP), examine how specific components of the change relate to key health outcomes and explore environmental, organizational and financial conditions that are conducive to transformational change. The aims of this study are to 1) confirm the transformational change process that has occurred within 40 selected practices in the NC IPIP, 2) evaluate which components of change are most linked with improvement in the quality care indicators for diabetes and asthma, 3) for a subset of 12 practices that evidence varying degrees of success in implementing transformational change, utilize quantitative and qualitative methods to obtain a richer understanding of the change process, examine the effect of environmental conditions, organizational characteristics and financial resources on the change process and describe the costs involved in transformational change at the practice level, and 4) provide a set of recommendations that can be applied at the individual practice level and at the health care organization level to assist in the PCMH transformation process. The ultimate goal and the significance of this study is to describe the transformation process and arrive at a set of implementable recommendations that can be shared broadly to assist individual practices and health care organizations moving toward the PCMH model. PUBLIC HEALTH RELEVANCE: The Patient-Centered Medical Home (PCMH) describes a health care setting that facilitates partnerships between individual patients and their personal physicians. The PCMH model improves patient access to care and quality of care. In this study, the researchers plan to evaluate the adoption and process of this transformational change and examine how specific components of the change relate to key health outcomes. This project is highly relevant to public health as it will enhance understanding of the transformation process in practice and provide a set of implementable recommendations that can be shared broadly to assist individual practices and health care organizations moving toward the PCMH model.

描述（由申请人提供）：以患者为中心的医疗之家（PCMH）模式涉及完整的初级护理实践重新设计，最终目标是提高患者护理质量并降低成本。需要关于实践转变最佳方法的详细信息，以帮助越来越多的实践计划完成这一过程。本研究的总体目标是评估采用和过程中的初级保健的做法属于北卡罗来纳州提高性能的实践计划（NC IPIP）的转型变革，研究如何具体组成部分的变化与关键的健康结果，并探讨环境，组织和财务条件，有利于转型变革。本研究的目的是：1）确认NC IPIP中40个选定实践中发生的转型变革过程，2）评估哪些变革组成部分与糖尿病和哮喘质量护理指标的改善最相关，3）对于12个实践子集，这些实践证明在实施转型变革方面取得了不同程度的成功，利用定量和定性方法，更深入地了解变革进程，审查环境条件、组织特点和财政资源对变革进程的影响，并说明在业务一级进行转型变革所涉的费用，以及4）提供一组可应用于个人实践水平和卫生保健组织水平的建议，以协助PCMH转型过程。本研究的最终目标和意义是描述转型过程，并得出一套可实施的建议，可以广泛共享，以帮助个人的做法和医疗机构走向PCMH模式。 公共卫生相关性：以患者为中心的医疗之家（PCMH）描述了一种促进个体患者及其私人医生之间的伙伴关系的医疗保健环境。PCMH模式改善了患者获得护理的机会和护理质量。在这项研究中，研究人员计划评估这种转型变革的采用和过程，并研究变革的具体组成部分与关键健康结果的关系。该项目与公共卫生高度相关，因为它将增强对实践中转型过程的理解，并提供一套可实施的建议，可以广泛分享，以帮助个人实践和医疗保健组织走向PCMH模式。