Articles: professional-practice.
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Annals of family medicine · Aug 2019
Practice Transformation Under the University of Colorado's Primary Care Redesign Model.
We compared the transformation experience of 2 family medicine practices that implemented the Primary Care Redesign (PCR) team-based model to improve access, quality, and experience without increasing cost. The University of Colorado's A.F. Williams Family Medicine clinic (pilot practice) implemented the model in February 2015, and a smaller, community-based practice (wave 2 practice) did so 2 years later, in February 2017. ⋯ The PCR model is associated with simultaneous improvements in quality, access, and clinician experience, as well as reductions in burnout, while maintaining staffing costs.
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In this study, we evaluated family physicians' ability to estimate the service area of their patient panel-a critical first step in contextual population-based primary care. We surveyed 14 clinicians and administrators from 6 practices. ⋯ Average overlap was 75%, but participants overestimated their service area by an average of 166 square miles. Service area overestimation impedes implementation of targeted community interventions by practices.
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Annals of family medicine · Aug 2019
Multicenter StudyA Longitudinal Study of Trends in Burnout During Primary Care Transformation.
The quadruple aim of primary care transformation includes promoting well-being among the primary care workforce. We longitudinally assessed burnout among clinicians and staff in 2 health delivery organizations engaged in primary care redesign guided by a shared transformation model. ⋯ The divergent trends of steady reduction in clinician burnout in one system and clinician burnout getting worse before getting better in the other system suggest that the effects of primary care transformation are influenced by the organizational context. Moreover, practice changes that reduce clinician burnout may not decrease-and may potentially even worsen-burnout among staff. Primary care transformation requires continuing efforts to promote meaningful work and sustainable workloads among all members of the primary care team.
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Annals of family medicine · Aug 2019
Clinician Perspectives on the Benefits of Practice Facilitation for Small Primary Care Practices.
Small independent primary care practices (SIPs) often lack the resources to implement system changes. HealthyHearts NYC, funded through the EvidenceNOW initiative of the Agency for Healthcare Research and Quality, studied the effectiveness of practice facilitation to improve cardiovascular disease- related care in 257 SIPs. We sought to understand SIP clinicians' perspectives on the benefits of practice facilitation. ⋯ SIP clinicians perceived practice facilitation to be an important resource for connecting their practice to the external health care environment and resources, and helping their practice build QI capacity through teaching, hands-on support, and EHR-driven solutions.