PT - JOURNAL ARTICLE AU - Day, Julie AU - Scammon, Debra L. AU - Kim, Jaewhan AU - Sheets-Mervis, Annie AU - Day, Rachel AU - Tomoaia-Cotisel, Andrada AU - Waitzman, Norman J. AU - Magill, Michael K. TI - Quality, Satisfaction, and Financial Efficiency Associated With Elements of Primary Care Practice Transformation: Preliminary Findings AID - 10.1370/afm.1475 DP - 2013 May 01 TA - The Annals of Family Medicine PG - S50--S59 VI - 11 IP - Suppl 1 4099 - http://www.annfammed.org/content/11/Suppl_1/S50.short 4100 - http://www.annfammed.org/content/11/Suppl_1/S50.full SO - Ann Fam Med2013 May 01; 11 AB - PURPOSE We examined quality, satisfaction, financial, and productivity outcomes associated with implementation of Care by Design (CBD), the University of Utah’s version of the patient-centered medical home. METHODS We measured the implementation of individual elements of CBD using a combination of observation, chart audit, and collection of data from operational reports. We assessed correlations between level of implementation of each element and measures of quality, patient and clinician satisfaction, financial performance, and efficiency. RESULTS Team function elements had positive correlations (P ≤.05) with 6 quality measures, 4 patient satisfaction measure, and 3 clinician satisfaction measures. Continuity elements had positive correlations with 2 satisfaction measures and 1 quality measure. Clinician continuity was the key driver in the composite element of appropriate access. Unexpected findings included the negative correlation of use of templated questionnaires with 3 patient satisfaction measures. Trade-offs were observed for performance of blood draws in the examination room and the efficiency of visits, with some positive and some negative correlations depending on the outcome. CONCLUSIONS Elements related to care teams and continuity appear to be key elements of CBD as they influence all 3 CBD organizing principles: appropriate access, care teams, and planned care. These relationships, as well as unexpected, unfavorable ones, require further study and refined analyses to identify causal associations.