Summary of Significant Correlations (P ≤.05) Between Care by Design Elements and Outcome
| CBD Element | Quality Measures | Patient Satisfaction | Clinician Satisfaction | Productivity and Cost |
|---|---|---|---|---|
| Appropriate access | ||||
| Same-day appointment | Pneumovax vaccination (−0.66) | – | – | Clinician cost/WRVU (0.74) Staff cost/clinician FTE (−0.87) WRVU/clinician (−0.83) Visits/clinician (−0.89) |
| Primary care clinician continuity | Influenza vaccination (0.68) | Likelihood to recommend (0.72) | – | – |
| Response to messages | Diabetes patient BP <140/80 mm Hg (−0.64) | Wait time at clinic (−0.75) Friendliness/courtesy of clinician (−0.68) Likelihood to recommend (−0.64) | – | |
| Abandonment rate | ACE inhibitor/ARB (−0.70) | – | Continuity of patient care able to provide (−0.64) | Clinician cost/WRVU (−0.66) |
| Calls answered within standard | Patients with AF prescribed warfarin therapy (−0.66) | Mammogram (0.70) | Time you spend working (−0.84) | Staff cost/clinician FTE (0.78) Visits/clinician FTE (0.69) |
| Patients signed up for MyCharta | Warfarin (−0.71) Eye examination (−0.80) | – | – | – |
| Care teams | ||||
| X-filesb | – | Explanation of care (−0.70) Instructions clinician gave (−0.68) Likelihood to recommend (−0.77) | – | – |
| Physical template | HbA1c test (−0.63) Influenza vaccination (−0.63) | – | – | Staff cost/clinician (−0.82) Visits/clinician (−0.69) |
| Best Practice Alerts | LDL-C treatment (−0.65) | – | – | – |
| Standard examination room | HbA1c <9% (−0.70) | – | Not enough support staff (0.79) | Staff cost/WRVU (0.64) WRVU/clinician (−0.75) Visits/clinician (−0.73) |
| Efficient visit | Lipid profile (−0.75) CAD patient LDL-C <100 mg/dL (−0.64) Diabetes patient LDL-C test (−0.72) | Wait time at clinic (0.79) | Time you spend (−0.71) | – |
| Huddles | LV assessment (0.78) | _ | – | – |
| Blood draw in room | – | Overall satisfaction (0.68) Wait time at clinic (0.66) | Your relationship with patients (0.71) | Net revenue (−0.68) Staff cost/clinician (−0.76) Clinician cost/WRVU (0.73) WRVU/clinician (−0.65) |
| Continuity of the MA | – | Friendliness/courtesy of clinician (0.82) | – | – |
| MA engagement | BP <140/80 mm Hg (0.63) Breast cancer screening (0.64) | – | – | – |
| Documented patient communication needs | – | – | – | Staff cost/WRVU (0.64) WRVU/clinician (−0.74) |
| Presence of advance directives | Diabetes patient LDL-C <100 mg/dL (0.72) HbA1c <9% (0.70) Urine protein (0.81) | Friendliness/ courtesy of clinician (−0.69) Information clinician gave (−0.69) Amount of time clinician spent (−0.75) Likelihood to recommend (−0.79) | – | – |
| Depression screen | – | Amount of time clinician spent (−0.62) | – | – |
| List of common resources | Diabetes patient LDL-C <100 mg/dL (−0.66) Colon cancer screening (−0.71) Influenza vaccination (−0.69) | – | Morale of group (0.88) | – |
| Efficient communication | Antiplatelet therapy (−0.68) | – | Volume of patient load reasonable (−0.70) Not enough support staff (−0.73) Quality of care able to give (−0.59) | – |
| Planned care | ||||
| Registries | – | – | Volume of patient load reasonable (−0.70) Continuity of care you are able to provide (−0.77) | Clinician cost/visit (−0.81) Clinician cost/WRVU (−0.76) |
| Labs done prior to visit | – | – | Morale of group (−0.67) | – |
| After-Visit Summary given | β-blocker (0.64) Diabetic patient LDL-C <100 mg/dL (0.67) LV assessment (0.67) Patient heart failure education (0.67) | – | – | Net revenue (0.64) |
| Medicine reconciliation | Patient heart failure education (0.79) | – | EHR improved my practice (−0.79) | Staff cost/visit (0.71) Staff cost/WRVU (0.74) |
| Procedure/consults notes available | Warfarin (−0.72) | – | – | – |
| Care plan documented | Warfarin (−0.77) | – | Time you spent working (−0.70) Continuity of care you are able to provide (−0.69) | – |
| Progress on care plan | Warfarin (−0.77) | – | – | – |
| Contact patients postdischarge | HbA1c <9% (0.68) Diabetic patient LDL-C test (0.68) Diabetic patient LDL-C <100 mg/dL (0.68) Urine protein (0.70) Pneumovax (0.70) | Overall satisfaction (−0.70) | Quality of care able to give (−0.71) | Staff cost/clinician (0.68) |
| Composite scores | ||||
| Appropriate access | Warfarin (−0.64) | Explanation of care (0.67) Instructions clinician gave (0.72) Likelihood to recommend (0.76) | – | – |
| Care teams | – | Overall satisfaction (0.67) | Time you spend working (0.68) Your relationship with patient (0.72) | Staff cost/clinician (−0.94) Visits/clinician (−0.70) |
ACE = angiotensin-converting enzyme; ARB = angiotensin receptor blocker; BP =blood pressure; CAD = coronary artery disease; CBD=Care by Design; EHR=electronic health record; LV = left ventricle; LDL-C = low-density lipoprotein cholesterol; MA = medical assistant; HbA1c=hemoglobin A1c; WRVU = work relative value unit.
Note: Values in parentheses are correlation coefficients.
↵a A patient portal in the EHR.
↵b A patient history template in the EHR.