Key Factors Supporting Higher-Performing Practices
Key Factor | Description |
---|---|
Health information technology | Early adoption of EHRs (4 of 5 higher-performing practices had EHRs in place =2 years before PCMH implementation) |
Administrative leadership | Highly engaged practice administrators who championed the PCMH transformation |
Clinician leadership | Regular clinician meetings to discuss performance, agree on clinical guidelines, and establish standards of care |
Shared vision and buy-in | Careful articulation and reinforcement of how the medical home will help patients and the practice and the need for changes |
Staff development | Team orientation and early development of medical assistant role |
Focus on improvement | Meetings revolve around PCMH and clinical quality improvement |
Shared decision making | Feedback from practice consistently sought on changes before, during, and after implementation |
Accountability | Clear roles and responsibilities and accountability to these roles and responsibilities |
Finances | Stable billing and administrative systems |
Financial autonomy | Direct receipt of and ability to invest PCMH financial incentives |
Benchmarking | Monthly clinician-specific benchmarking to identify best practices and breakdowns in PCMH processes |
Reporting and documentation | Careful attention to data reporting and documentation of PCMH changes |
Inclusivity | Collective problem solving and open communication |
Staff stability | Minimal staff turnover |
EHR = electronic health record; PCMH = patient-centered medical home.
Note: A variety of factors supported PCMH implementation in the higher-performing practices.
Source: Site visit observations and semistructured interviews in the higher-performing practices.