RT Journal Article
SR Electronic
T1 Physician Satisfaction with Chronic Care Processes: A Cluster-Randomized Trial of Guided Care
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 308
OP 315
DO 10.1370/afm.1134
VO 8
IS 4
A1 Jill A. Marsteller
A1 Yea-Jen Hsu
A1 Lisa Reider
A1 Katherine Frey
A1 Jennifer Wolff
A1 Cynthia Boyd
A1 Bruce Leff
A1 Lya Karm
A1 Daniel Scharfstein
A1 Chad Boult
YR 2010
UL http://www.annfammed.org/content/8/4/308.abstract
AB PURPOSE Chronically ill older patients with multiple conditions are challenging to care for, and new models of care for this population are needed. This study evaluates the effect of the Guided Care model on primary care physicians’ impressions of processes of care for chronically ill older patients. METHODS In Guided Care a specially educated registered nurse works at the practice with 2 to 5 primary care physicians, performing 8 clinical activities for 50 to 60 chronically ill older patients. The care model was tested in a cluster-randomized controlled trial between 2006 and 2009. All eligible primary care physicians in 14 pods (teams of physicians and their chronically ill older patients) agreed to participate (n = 49). Pods were randomly assigned to provide either Guided Care or usual care. Physicians were surveyed at baseline and 1 year later. We assessed the effects of Guided Care using responses from 38 physicians who completed both survey questionnaires. We measured physicians’ satisfaction with chronic care processes, time spent on chronic care, knowledge of their chronically ill older patients, and care coordination provided by physicians and office staff. RESULTS Compared with the physicians in the control group, those in the Guided Care group rated their satisfaction with patient/family communication and their knowledge of the clinical characteristics of their chronically ill older patients significantly higher (ρ<0.05 in linear regression models). Other differences did not reach statistical significance. CONCLUSIONS Based on physician report, Guided Care provides important benefits to physicians by improving communication with chronically ill older patients and their families and in physicians’ knowledge of their patients’ clinical conditions.