HEROs: New Mexico's Health Extension as a Model for Primary Care Transformation t

描述(由申请人提供)：HEROS：新墨西哥州的健康扩展作为通过协作和共享资源进行初级保健转型的典范本提案中概述的项目摘要/摘要是新墨西哥州日益增长的组织网络的回应，作为共享资源，在将中小型初级保健实践转变为以患者为中心的医疗之家(PCMH)方面进行合作。新墨西哥州为解决资源匮乏、人手不足的小型做法的障碍而创建的转型模式是卫生推广农村办公室(HEROS)，这是一种以社区为基础、与大学挂钩的模式，可以在其他州和全国范围内采用。本提案中描述的模式改进将增加一系列实践改进战略，并进一步支持现有的努力，扩展HEROS模式将导致实现以下五个具体目标：“健康推广作为初级保健实践转型的催化剂”HEROS工作人员作为初级保健实践转型教练“采用初级保健实践的质量改进模式和策略”全国初级保健推广服务的可扩展模式初级保健推广模式的评估和传播为实现这些目标，隶属于新墨西哥大学健康科学中心(UNM HSC)的五个地区健康推广乡村办公室(HEROS)的工作人员将提供技术援助，提供共享资源菜单，帮助实践者在两年的授权期内逐步向PCMH转型。一个代表主要的全州项目的核心团队将支持HEROS员工的工作，这些项目提供PCMH转型的主要实践组件(从信息技术到质量改进再到远程医疗)。这笔赠款将促进这些项目之间史无前例的资源共享，以加快PCMH的转型。一个健全的评价计划将从数量和质量两个方面跟踪转型进程的有效性。数据收集工具和措施包括组织为变革做好准备、NCQA以患者为中心的医疗之家检查表、实践指导有效性仪表板、HERO活动日志、数据管理计划的充分性和数据分析计划。一项全面的传播将包括一个初级保健保健扩展工具包，该工具包由新墨西哥州核心小组与其在其他三个州(堪萨斯州、肯塔基州和俄勒冈州)的传播伙伴共同开发，用于网上传播。HEROS计划将在全国范围内扩大并在州内持续实施，到第五年，新墨西哥州所有约100家独立的小型初级保健诊所都将获得PCMH资格。 公共卫生相关性：英雄：新墨西哥州的健康扩展作为通过合作和共享资源项目实现初级保健转型的典范项目叙述初级保健实践向以患者为中心的医疗之家(PCMH)的转变对于资源匮乏、人手不足、规模较小的初级保健实践来说是困难的。新墨西哥州将采用基本战略来应对初级保健基础设施和实践转型的挑战，这是一个以社区为基础的、全州范围的、但与大学有关联的代理人网络，可以协助和支持中小型初级保健实践和最佳循证实践，以支持提供高质量的保健和实践转型。健康推广将学术卫生中心、公共卫生和其他州机构、信息技术和项目的共享资源调动到该州的农村和城市、主要是少数族裔和服务不足的社区，这些社区依赖当地的初级保健做法立即获得医疗保健。

DESCRIPTION (provided by applicant): HEROs: New Mexico's Health Extension as a Model for Primary Care Transformation through Collaboration and Shared Resources Project Summary/Abstract Outlined in this proposal is the response from a growing network of organizations in New Mexico, collaborating as a shared resource in the transformation of small to medium sized primary care practices to patient-centered medical homes (PCMHs). The transformation model created in New Mexico to address barriers for resource- poor, understaffed small practices is Health Extension Rural Offices (HEROs), which is a community-based, University-linked model that can be adapted in other states and nationally. The model enhancements described in this proposal will add an array of practice improvement strategies and further support existing efforts and the expansion of the HEROs model will lead to accomplishing the following five specific aims: " Health Extension as a Catalyst for Primary Care Practice Transformation " HEROs Staff as Primary Care Practice Transformation Coaches " Adoption of Quality Improvement Models and Strategies by Primary Care Practices " A Scalable Model for a National Primary Care Extension Service " Evaluation and Dissemination of the Primary Care Extension Model To achieve these aims, staff of five, regional Health Extension Rural Offices (HEROs) affiliated with the University of New Mexico Health Sciences Center (UNM HSC) will provide technical assistance, offering a menu of shared resources to help practices make incremental transformation toward a PCMH over the two year grant period. A Core Team representing major, statewide programs that provide primary practices with components of PCMH transformation (from Information Technology to Quality Improvement to Telehealth) will support the work of the HEROs staff. This grant will facilitate an unprecedented sharing of resources between these programs to accelerate PCMH transformation. A robust evaluation plan will track the effectiveness of the transformation process in quantitative and qualitative dimensions. Data collection instrument and measures include Organizational Readiness for Change, NCQA Patient-Centered Medical Home Checklist, Practice Coaching Effectiveness Dashboard, HERO Activities Log, Adequacy of Data Management Plan, and a Data Analysis Plan. A comprehensive dissemination will feature a Primary Care Health Extension Toolkit, jointly developed by the New Mexico Core Team with its dissemination partners in three other states (Kansas, Kentucky and Oregon) for web-based dissemination. The HEROs program will be scaled up nationally and sustained in-state with all ~100 independent, small primary care practices in New Mexico achieving PCMH status by year five. PUBLIC HEALTH RELEVANCE: HEROs: New Mexico's Health Extension as a Model for Primary Care Transformation through Collaboration and Shared Resources Project Narrative Primary care practice transformation to a patient-centered medical home (PCMH) is difficult for resource-poor, understaffed, small primary care practices. The fundamental strategy New Mexico will employ to address the challenges to primary care infrastructure and practice transformation is the concept of Health Extension (a program known as "HEROs"), a community-based, state-wide, but university-linked network of agents that can assist and support small and medium sized primary care practices with the best evidence-based practices to support the provision of quality care and practice transformation. Health Extension mobilizes shared resources of the academic health center, public health and other state agencies, information technology and programs to the state's rural and urban, predominantly minority, and underserved communities that depend on local primary care practices for immediate access to health care.