TY - JOUR
KW - Evidence-Based Practice
KW - Family Practice/organization & administration/standards/trends
KW - Humans
KW - Models, Organizational
KW - Organizational Innovation
KW - Outcome and Process Assessment (Health Care)
KW - Patient-Centered Care/organization & administration/standards/trends
KW - Quality Assurance, Health Care/methods/organization & administration/standards
KW - United States
AU - B. F. Crabtree
AU - P. A. Nutting
AU - W. L. Miller
AU - K. C. Stange
AU - E. E. Stewart
AU - C. R. Jaen
A1 - 
AB - This article summarizes findings from the National Demonstration Project (NDP) and makes recommendations for policy makers and those implementing patient-centered medical homes (PCMHs) based on these findings and an understanding of diverse efforts to transform primary care. The NDP was launched in June 2006 as the first national test of a particular PCMH model in a diverse sample of 36 family practices, randomized to facilitated or self-directed groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical record audits, and patient and clinical staff surveys. Peer-reviewed manuscripts from the NDP provide answers to 4 key questions: (1) Can the NDP model be built? (2) What does it take to build the NDP model? (3) Does the NDP model make a difference in quality of care? and (4) Can the NDP model be widely disseminated? We find that although it is feasible to transform independent practices into the NDP conceptualization of a PCMH, this transformation requires tremendous effort and motivation, and benefits from external support. Most practices will need additional resources for this magnitude of transformation. Recommendations focus on the need for the PCMH model to continue to evolve, for delivery system reform, and for sufficient resources for implementing personal and practice development plans. In the meantime, we find that much can be done before larger health system reform.
BT - Annals of family medicine
C5 - Medical Home; Healthcare Policy
CY - United States
DO - 10.1370/afm.1107
JF - Annals of family medicine
N2 - This article summarizes findings from the National Demonstration Project (NDP) and makes recommendations for policy makers and those implementing patient-centered medical homes (PCMHs) based on these findings and an understanding of diverse efforts to transform primary care. The NDP was launched in June 2006 as the first national test of a particular PCMH model in a diverse sample of 36 family practices, randomized to facilitated or self-directed groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical record audits, and patient and clinical staff surveys. Peer-reviewed manuscripts from the NDP provide answers to 4 key questions: (1) Can the NDP model be built? (2) What does it take to build the NDP model? (3) Does the NDP model make a difference in quality of care? and (4) Can the NDP model be widely disseminated? We find that although it is feasible to transform independent practices into the NDP conceptualization of a PCMH, this transformation requires tremendous effort and motivation, and benefits from external support. Most practices will need additional resources for this magnitude of transformation. Recommendations focus on the need for the PCMH model to continue to evolve, for delivery system reform, and for sufficient resources for implementing personal and practice development plans. In the meantime, we find that much can be done before larger health system reform.
PP - United States
PY - 2010
SN - 1544-1717; 1544-1709
EP - 90; S92
EP - S80+
T1 - Summary of the National Demonstration Project and recommendations for the patient-centered medical home
T2 - Annals of family medicine
TI - Summary of the National Demonstration Project and recommendations for the patient-centered medical home
U1 - Medical Home; Healthcare Policy
U2 - 20530397
U3 - 10.1370/afm.1107
VL - 8 Suppl 1
VO - 1544-1717; 1544-1709
Y1 - 2010
ER -