Table 2.

Definitions, Benefits, and Outcomes of PVP Described by Key Informants

Thematic CategoryDescriptionExample Quote
PVP as defined by clinicians
  • Being prepared or organized for a patient’s visit typically by reviewing charts for scheduled patients in advance

  • Anticipating the patient’s needs

  • Prioritizing the patient’s needs during a visit

“Getting ready to see each patient in a way that you can use the time most effectively. So having some time to flip through the chart and figure out their last visit, what they were worried about, think about what they might need this visit. Looking at what healthcare maintenance might be due, what vaccines might be due. So you can get ready to be there and not having to completely spend your entire time flipping through the records.” (Key informant 03J
Benefits of PVP as perceived by cliniciansPerceived benefits for patients:
  • Perception that patients have a more comprehensive and meaningful visit

Patient priorities for the visit are met Perceived benefits for clinicians:
  • Perception by clinicians that they provide better care and know their patients better

  • Fewer surprises during a clinical encounter

  • Less follow up work at the end of the day

“For us, the physicians, professionally, it was really a matter of doing the kind of work that we want to do. You know, a lot of this chasing down of these quality goals that are top of mind of the administrators isn’t often the way we’d love to spend our time with patients. A lot of that documentation is tedious and time consuming and it just feels bad, to do the wrong kind of work. So a big thing is to try to make sure that we are each spending as much time as we can doing what we are uniquely trained to do.” (Key informant 11)
Important outcomes to demonstrate with PVPPatient outcomes
  • Improved communication with clinicians; patients feel engaged in their care and talk about what’s important to them

  • Patient’s short-, medium-, and long-term goals are met

Clinician outcomes
  • Less work for clinicians and staff such as less time is spent charting or fielding calls because more things have been dealt with during the visit

  • Increased joy of practice and reduced physician burnout

Process outcomes
  • Time savings in visit

  • Better quality metrics due to closing care gaps, eg, higher vaccination rates

  • Work distributed effectively among the team, eg, more covered by the MA during the rooming process

“And we see that physicians who don’t do pre-visit planning are taking a lot of work home. They’re frustrated and they’re burning out. And we know that over 50% of physicians in this country are experiencing some symptom of burnout. A burntout physician is more likely to make a medication error, have patients who are dissatisfied with their experience and their outcomes are worse.” (Key informant 07)
  • MA = medical assistant; PVP = pre-visit planning.