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保健实践重新设计，最终目标是提高患者护理质量并降低成本。需要有关实践转型最佳方法的详细信息来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属于北卡罗来纳州改善实践绩效计划 (NC IPIP) 的初级保健实践转型变革的采用和过程，研究变革的具体组成部分如何与关键健康结果相关，并探索环境有利于转型变革的组织和财务条件。本研究的目的是 1) 确认 NC IPIP 40 个选定实践中发生的转型变革过程，2) 评估变革的哪些组成部分与糖尿病和哮喘质量护理指标的改善最相关，3)对于证明在实施转型变革方面取得不同程度成功的 12 种实践的子集，利用定量和定性方法来更丰富地了解变革过程，检查环境条件、组织特征和财务资源对变革过程的影响，并描述所涉及的费用实践层面的转型变革，4) 提供一组可应用于个人实践层面和医疗保健组织层面的建议，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，并得出一系列可实施的建议，这些建议可以广泛共享，以帮助个人实践和医疗保健组织迈向 PCMH 模式。 公共健康相关性：以患者为中心的医疗之家 (PCMH) 描述了一种促进个体患者与其私人医生之间合作的医疗保健环境。 PCMH 模型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一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，并提供一套可广泛共享的可实施建议，以帮助个人实践和医疗保健组织迈向 PCMH 模式。