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Research ArticleEditorial

Lessons Learned From the Study of Primary Care Transformation

Robert J. McNellis, Janice L. Genevro and David S. Meyers
The Annals of Family Medicine May 2013, 11 (Suppl 1) S1-S5; DOI: https://doi.org/10.1370/afm.1548
Robert J. McNellis
Agency for Healthcare Research and Quality
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  • For correspondence: robert.mcnellis@ahrq.hhs.gov
Janice L. Genevro
Agency for Healthcare Research and Quality
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David S. Meyers
Agency for Healthcare Research and Quality
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    Table 1

    Overarching Findings

    1. A strong foundation is needed for successful redesign

      Existing structural capacity (electronic health records, operations management, organizational size, and resources)

      Broad organizational support

      Previous experience with teams

      Financial stability

      Focus, commitment, and few distractions

    2. The process of transformation can be a long and difficult journey

      Ambitious and challenging, and requires time

      Dynamic and time intensive with ebbs and flows

      Requires deep changes in structures and systems

      Tensions and trade-offs should be expected

    3. Approaches to transformation vary

      Increased or expanded use of team-based care

      Expanded patient access and improved coordination

      Data-driven measurement and feedback

      Formal or informal learning collaboratives

    4. Visionary leadership and a supportive culture ease the way for change

      Strong leadership with vision for change at all levels

      Communication with staff and patients

      Cultural attributes (collaboration, respect, accountability)

      Alignment of incentives and rewards

      Mission-based focus

    5. Contextual factors are inextricably linked to outcome

      National, state, and local policies

      Dynamics of the health system or related systems

      Influence of the community and other stakeholders

      Financial incentives

      Staff dynamics and characteristics

      Approach to transformation

Additional Files

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    Supplemental Table 1. Characteristics of the 14 Projects

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    • Supplemental data: Table - PDF file, 5 pages, 229 KB
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The Annals of Family Medicine: 11 (Suppl 1)
The Annals of Family Medicine
Vol. 11, Issue Suppl 1
May/June 2013
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Lessons Learned From the Study of Primary Care Transformation
Robert J. McNellis, Janice L. Genevro, David S. Meyers
The Annals of Family Medicine May 2013, 11 (Suppl 1) S1-S5; DOI: 10.1370/afm.1548

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Lessons Learned From the Study of Primary Care Transformation
Robert J. McNellis, Janice L. Genevro, David S. Meyers
The Annals of Family Medicine May 2013, 11 (Suppl 1) S1-S5; DOI: 10.1370/afm.1548
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  • Article
    • CHARACTERISTICS OF THE PROJECTS
    • KEY LESSONS LEARNED ABOUT TRANSFORMATION
    • OTHER LESSONS LEARNED
    • CONCLUSIONS
    • Acknowledgments
    • Footnotes
    • References
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  • The Transition of Primary Care Group Practices to Next Generation Models: Satisfaction of Staff, Clinicians, and Patients
  • Lessons From Early Implementation of a Patient-Centered Care Model in Oncology
  • Recommendations for a Mixed Methods Approach to Evaluating the Patient-Centered Medical Home
  • Validation of 2 New Measures of Continuity of Care Based on Year-to-Year Follow-up With Known Providers of Health Care
  • Challenges of Medical Home Transformation Reported by 118 Patient-Centered Medical Home (PCMH) Leaders
  • Patient-Centered Medical Home (PCMH) Recognition: A Time for Promoting Innovation, Not Measuring Standards
  • The Quest for Effective Care Coordination
  • Practice Transformation? Opportunities and Costs for Primary Care Practices
  • In This Issue: Practice Change--Context Matters
  • Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change
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Subjects

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    • Health policy
  • Other topics:
    • Patient-centered medical home
    • Organizational / practice change

Keywords

  • patient-centered medical home
  • primary care
  • change
  • organizational
  • practice-based research
  • certification
  • change management

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