Abstract:
RATIONALE, AIMS, AND OBJECTIVES:The patient-centred medical home (PCMH) is an innovative approach to health care reform. Despite a well-established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the connection between fidelity/adaptation to the PCMH model with implementation successes and challenges through the experiences of family and internal medicine PCMH physicians. METHODS:Interviews were conducted at two academic PCMH clinics with faculty and resident physicians. Data were transcribed and coded on the basis of an a priori code list. Together, the authors reviewed text and furthered the analysis process to reach final interpretation of the data. RESULTS:Ten faculty and nine resident physicians from the Family Care Centre (FCC; n = 11) and the Internal Medicine Clinic (IMC; n = 8) were interviewed. Both FCC and IMC physicians spoke positively about their clinic's adherence to the PCMH model of enhanced access to care, coordinated/integrated care, and improvements in quality and safety through data collection and documentation. However, physicians highlighted inadequate staffing and clinic hours. FCC physicians also discussed the challenge of providing high-quality care amidst differences in coverage between payers. CONCLUSION:There remains significant variability in PCMH characteristics across the United States and Canada. This qualitative analysis uncovered factors contributing to fidelity/adaptation to the PCMH model in two academic PCMH clinics. For the PCMH to achieve the Triple Aim promise of improved patient health and experience at a reduced cost, policy must support fidelity to core elements of the PCMH.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Sklar M,Seijo C,Goldman RE,Eaton CBdoi
10.1111/jep.13136subject
Has Abstractpub_date
2019-12-01 00:00:00pages
1142-1151issue
6eissn
1356-1294issn
1365-2753journal_volume
25pub_type
杂志文章abstract:RATIONALE:Recent reports indicate that approximately 10% of in-patients in UK hospitals are involved in an adverse event (these reports also state that 50% of these events are preventable). This is indeed a worrying finding, and indicates the need to look at how these incidents are handled or indeed, what is done to mi...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01759.x
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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journal_title:Journal of evaluation in clinical practice
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