Article Figures & Data
Tables
- Table 1
Organizational Factors to Consider When Implementing Peer Support Initiatives in Medical Homes
Structure Uniform guidelines for determining eligibility, recruitment, and selection of peer support candidates. Clear standards that define responsibilities, scope of work, competencies, performance standards, and reporting relationships that are tied to licensed professionals, such as nurses or social workers, in the medical home. Operating procedures and back-up plans that allow peer supporters direct access to professional staff in the event of urgent or life threatening circumstances. Clinical information systems that allow effective communication, at the appropriate level of patient health information, between peer supporters and professional staff. Process Orientation and ongoing training for peer support workers in interpersonal and communication skills, documentation and other administrative skills, and content and teaching skills for specific health promotion areas. Effective dissemination of peer support services to medical home staff, area health care affiliates, and community stakeholders. Ongoing monitoring of peer support services provided, with appropriate supervision. Communication and documentation of peer support activities in a database that is accessible to medical home staff and retrievable for reporting and evaluation. Outcomes Clear and measurable goals and objectives in the following short-term and intermediate areas: patient-level outcomes, such as health and functional status measures; biometric and other disease state measures; patient-centered and other individual care process measures; organizational-level outcomes, such as access to care, health care utilization, costs of care and savings; and community-level outcomes, such as social capital. Comparative effectiveness What are the differential effects of peer support interventions that are targeted to patient disease states (eg, diabetes, depression), medical comorbidities, and demographic characteristics? What is the incremental benefit of peer support interventions for patients who are already engaged in behavior or self-management programs? How can peer support interventions interface effectively with emerging health information technologies to improve care? Cost-effectiveness What is the cost-effectiveness of peer support programs compared with other behavior and disease management programs? What are the indirect benefits of peer support programs to medical homes? What are the financial models that can provide for the sustained viability of peer support programs in medical homes?
