TY - JOUR KW - Cooperative Behavior KW - Health Care Surveys/methods KW - Humans KW - Interinstitutional Relations KW - Longitudinal Studies KW - Models, Organizational KW - Outcome and Process Assessment (Health Care)/organization & administration KW - Patient-Centered Care/organization & administration KW - Primary Health Care/organization & administration KW - Professional Role KW - Quality of Health Care/organization & administration KW - Research Design KW - Systems Integration AU - B. F. Crabtree AU - S. M. Chase AU - C. G. Wise AU - G. D. Schiff AU - L. A. Schmidt AU - J. R. Goyzueta AU - R. A. Malouin AU - S. M. Payne AU - M. T. Quinn AU - P. A. Nutting AU - W. L. Miller AU - C. R. Jaen A1 - AB - BACKGROUND: The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. METHODS: Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. RESULTS: A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. CONCLUSIONS: Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures. BT - Medical care C5 - Medical Home CP - 1 CY - United States DO - 10.1097/MLR.0b013e3181f80766 IS - 1 JF - Medical care N2 - BACKGROUND: The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. METHODS: Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. RESULTS: A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. CONCLUSIONS: Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures. PP - United States PY - 2011 SN - 1537-1948; 0025-7079 SP - 10 EP - 16 EP - T1 - Evaluation of patient centered medical home practice transformation initiatives T2 - Medical care TI - Evaluation of patient centered medical home practice transformation initiatives U1 - Medical Home U2 - 21079525 U3 - 10.1097/MLR.0b013e3181f80766 VL - 49 VO - 1537-1948; 0025-7079 Y1 - 2011 ER -