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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
MPH, PA
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  • For correspondence: robert.mcnellis@ahrq.hhs.gov
Janice L. Genevro
Agency for Healthcare Research and Quality
PhD, MSW
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David S. Meyers
Agency for Healthcare Research and Quality
MD
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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

    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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In this issue

The Annals of Family Medicine: 11 (Suppl 1)
The Annals of Family Medicine: 11 (Suppl 1)
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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Cited By...

  • 'Trying to fly the plane while we were building it. Applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study
  • A Longitudinal Study of Trends in Burnout During Primary Care Transformation
  • Dissemination and Implementation Science in Primary Care Research and Practice: Contributions and Opportunities
  • EvidenceNOW: Balancing Primary Care Implementation and Implementation Research
  • A Randomized Trial of High-Value Change Using Practice Facilitation
  • 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
  • In This Issue: Practice Change--Context Matters
  • Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change
  • Practice Transformation? Opportunities and Costs for Primary Care Practices
  • Google Scholar

More in this TOC Section

  • Information Technology in Primary Care Screenings: Ready for Prime Time?
  • All Quality Metrics are Wrong; Some Quality Metrics Could Become Useful
  • The AI Moonshot: What We Need and What We Do Not
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Subjects

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

Keywords

  • patient-centered medical home
  • primary care
  • change
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  • change management

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