Primary Data Sources Analyzed Across Essential Medical Home Attributes
| Essential Medical Home Attribute | Primary Data Source | ||
|---|---|---|---|
| MHIa | Clinician Staff Questionnaireb | Semistructured Interviews | |
| Continuous QI | MHI domain of QI was most improved theme between precollaborative time point (3.16) and current time point (5.79) | AR mean score was 0.75; of 23 AR items, 12 relate to QI functions | Interviews emphasized QI as ongoing and enduring (rather than rapid, time-limited transformation) |
| FCC | MHI question about “practice knowledge and application” of FCC principles; 100% of cohort knowledgeable and sometimes (25%) or regularly (75%) apply FCC | Mean score for CMHI question on practice team “value of family engagement” was 0.80 | Interviews emphasized value of family involvement in the MHLC; this emphasis continues today; practice actions and materials emphasized FCC |
| Team-based care/teamwork | MHI scores converted to a 100-point scale improved overall between precollaborative and current time points (34%); concept of “team” integrated across the MHI | AR mean score was 0.75; AR is a measure of the team’s ability to make and sustain changes | Interviews highly emphasized teamwork and team attitude |
| CC (team-based CC) | MHI domain of CC improved between precollaborative time point (3.82) and current time point (6.39) | AR mean score was 0.75; combines and averages lead PCP and CC scores (as key team members) | Interviews of highest emphasis included quotes referencing CC, teamwork, and attitude (of 47% characteristic quotes 50% address) |
AR = adaptive reserve; CC = care coordination; CMHI = Center for Medical Home Improvement; FCC = family-centered care; MHI = Medical Home Index; MHLC = medical home learning collaborative; PCP = primary care provider; QI = quality improvement.
↵a MHI scale ranged from 1 to 8. Total MHI scores are expressed as a percentage of a maximum of 100.
↵b AR scores were transformed to a 100-point scale to allow comparison with MHI scores. AR scale ranged from 0.0 to 1.0.