TY - JOUR
KW - Family Practice/methods/organization & administration/trends
KW - Humans
KW - Models, Organizational
KW - Organizational Innovation
KW - Patient-Centered Care/methods/organization & administration/standards
KW - Program Development/methods
KW - Program Evaluation/methods
KW - Randomized Controlled Trials as Topic
AU - E. E. Stewart
AU - P. A. Nutting
AU - B. F. Crabtree
AU - K. C. Stange
AU - W. L. Miller
AU - C. R. Jaen
A1 - 
AB - PURPOSE: We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. METHODS: An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). RESULTS: The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. CONCLUSIONS: The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning.
BT - Annals of family medicine
C5 - Medical Home
CY - United States
DO - 10.1370/afm.1111
JF - Annals of family medicine
N2 - PURPOSE: We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. METHODS: An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). RESULTS: The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. CONCLUSIONS: The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning.
PP - United States
PY - 2010
SN - 1544-1717; 1544-1709
EP - 32; S92
EP - S21+
T1 - Implementing the patient-centered medical home: Observation and description of the National Demonstration Project
T2 - Annals of family medicine
TI - Implementing the patient-centered medical home: Observation and description of the National Demonstration Project
U1 - Medical Home
U2 - 20530392
U3 - 10.1370/afm.1111
VL - 8 Suppl 1
VO - 1544-1717; 1544-1709
Y1 - 2010
ER -