Patient-Centered Care in a Medical Home

2011 ◽  
Vol 16 (2) ◽  
Author(s):  
Colette Carver ◽  
Anne Jessie
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Patient Centered Medical Homes ◽  
Medical Homes ◽  
Centered Care ◽  
Medical Home Model

There is general consensus that our current healthcare delivery system will not be able to supply an adequate workforce, contain costs, and meet the ever-increasing chronic-care needs of the growing and aging population in the United States (US). Some of the major challenges to the U.S. healthcare system are faced by those on the front lines, namely the healthcare workers in primary care. Part of the emerging solution for primary care is the adoption of the Patient-Centered Medical Home Model. The intent of this model is to provide coordinated and comprehensive care rooted in a strong collaborative relationship. Carilion Clinic in Southwestern Virginia is implementing this patient-centered model in which a proactive, multidisciplinary care team collectively takes responsibility for each patient. In this article we will elaborate on the concepts of patient-centered care and patient-centered medical homes, after which we will offer an exemplar describing the process that Carilion Clinic is using to establish patient-centered medical homes throughout their primary care departments. Limitations of the Patient-Centered Medical Home Model will also be discussed.

scholarly journals Veteran Patient Perspectives and Experiences During Implementation of a Patient-Centered Medical Home Model

2017 ◽  
Vol 5 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Anaïs Tuepker ◽  
Summer Newell ◽  
Christina Nicolaidis ◽  
Marie-Elena Reyes ◽  
Maria Carolina González-Prats ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Home ◽  
Care Delivery ◽  
Hybrid Approach ◽  
The United States ◽  
Patient Centered Medical Home ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered

Background: The Veterans Health Administration (VA) has implemented the largest shift to a patient-centered medical home (PCMH) model of care in the United States to date. Objective: We interviewed veterans about their experiences of primary care to understand whether they observed changes in care during this period as well as to learn which characteristics of care mattered most to their experiences. Method: Qualitative interviews were conducted with 32 veterans receiving primary care at 1 of 8 VA clinics in the northwest United States. Interviews were analyzed using an inductive–deductive hybrid approach by an interdisciplinary team that included a veteran patient. Result: Participants noticed recent positive changes, including improved communications and shorter waits in clinic, but rarely were aware of VA’s PCMH initiative; a strong relationship with the primary care provider and feeling cared for/respected by everyone involved in care delivery were key components of quality care. The needs of the veteran community as a whole also shaped discussion of care expectations. Conclusion: The PCMH model may provide benefits even when invisible to patients. Veteran awareness of population needs suggests a promising role for veteran involvement in further PCMH transformation efforts.

scholarly journals Teaching in a Patient-Centered Medical Home

2011 ◽  
Vol 20 (3) ◽  
pp. 163-165 ◽  
Author(s):  
Barbara A. Hotelling
Keyword(s):  
Maternity Care ◽  
Medical Home ◽  
Evidence Based ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Patient Centered Medical Homes ◽  
Medical Homes ◽  
The Right ◽  
Evidence Based Care ◽  
Family Centered

Teaching Lamaze International classes in a patient-centered medical home allows the childbirth educator the best environment for giving evidence-based information and empowering parents to give birth their way. Patient-centered medical home facilities and providers practice evidence-based care and adhere to the principles of family-centered maternity care. In patient-centered medical homes, women can expect to give birth using the Lamaze Healthy Birth Practices and to fully participate in their care with appropriate interventions and the right to informed consent and informed refusal.

scholarly journals Patient centeredness: The perspectives of uninsured primary care patients in the United States

2019 ◽  
Vol 22 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Akiko Kamimura ◽  
Shannon Weaver ◽  
Bianca Armenta ◽  
Bethany Gull ◽  
Jeanie Ashby
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Outcomes ◽  
Patient Involvement ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care ◽  
Primary Care Patients

Introduction Patient-centered care has become increasingly important within the United States (US) healthcare system. Given that patient-centered care predicts patient satisfaction, health outcomes, and cost-effectiveness, it is of the utmost importance to study patient-centered care from the perspectives of marginalized populations including minorities, immigrants, and other underserved populations. The purpose of this study is to examine factors that affect underserved primary care patients’ perceptions of patient centeredness. Methods The data were cross-sectional and collected in Fall 2016. Free clinic patients (N = 723) completed a self-administered survey, which measures patient centeredness, patient involvement in care, and clinical empathy. Validated measures were part of the survey, and the internal consistency of scales was tested. The general linear model was performed to predict factors associated with patients’ perceptions of patient centeredness. Results Higher levels of perceived patient involvement in care and higher levels of perceived empathy in consultation are related to higher levels of patient centeredness. While better physical health is associated with higher levels of perceived empathy in consultation, high levels of emotional health and depression are not. Conclusions Patients’ perceptions of involvement and empathy are important factors for patient-centered care, although this study did not show causal directions among variables. Based on the findings of this study, it is recommended that future studies should focus on the following three points: (1) to develop and evaluate trainings for providers, (2) develop education classes for patients who utilize free clinics, (3) analyze how these programs affect patient-centered care and health outcomes.

Association of medical home team-based care functions and perceived improvements in patient-centered care at VHA primary care clinics

Healthcare ◽  
2014 ◽  
Vol 2 (4) ◽  
pp. 238-244 ◽  
Author(s):  
Christian D. Helfrich ◽  
Emily D. Dolan ◽  
Stephan D. Fihn ◽  
Hector P. Rodriguez ◽  
Lisa S. Meredith ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Home Team ◽  
Primary Care Clinics ◽  
Centered Care ◽  
Team Based Care

scholarly journals What matters in patient-centered medical home transformation: Whole system evaluation outcomes of the Brown Primary Care Transformation Initiative

2018 ◽  
Vol 6 ◽  
pp. 205031211878193
Author(s):  
Roberta E Goldman ◽  
Joanna Brown ◽  
Patricia Stebbins ◽  
Donna R Parker ◽  
Victoria Adewale ◽  
...  
Keyword(s):  
Primary Care ◽  
Rhode Island ◽  
Medical Home ◽  
Teaching Practice ◽  
The United States ◽  
Personal Accomplishment ◽  
System Evaluation ◽  
Patient Centered Medical Home ◽  
Implementation Barriers ◽  
Patient Centered

Objectives: Patient-centered medical home transformation initiatives for enhancing team-based, patient-centered primary care are widespread in the United States. However, there remain large gaps in our understanding of these efforts. This article reports findings from a contextual, whole system evaluation study of a transformation intervention at eight primary care teaching practice sites in Rhode Island. It provides a picture of system changes from the perspective of providers, staff, and patients in these practices. Methods: Quantitative/qualitative evaluation methods include patient, provider, and staff surveys and qualitative interviews; practice observations; and focus groups with the intervention facilitation team. Results: Patient satisfaction in the practices was high. Patients could describe observable elements of patient-centered medical home functioning, but they lacked explicit awareness of the patient-centered medical home model, and their activation decreased over time. Providers’ and staff’s emotional exhaustion and depersonalization increased slightly over the course of the intervention from baseline to follow-up, and personal accomplishment decreased slightly. Providers and staff expressed appreciation for the patient-centered medical home as an ideal model, variously implemented some important patient-centered medical home components, increased their understanding of patient-centered medical home as more than specific isolated parts, and recognized their evolving work roles in the medical home. However, frustration with implementation barriers and the added work burden they associated with patient-centered medical home persisted. Conclusion: Patient-centered medical home transformation is disruptive to practices, requiring enduring commitment of leadership and personnel at every level, yet the model continues to hold out promise for improved delivery of patient-centered primary care.

A Regional Survey on Residents’ Preferences on Patient-Centered Medical Home Design in Rural Areas

2018 ◽  
Vol 12 (3) ◽  
pp. 187-205
Author(s):  
Hui Cai ◽  
Kent Spreckelmeyer ◽  
Amy Mendenhall ◽  
Dan Li ◽  
Cheryl Holmes ◽  
...  
Keyword(s):  
Physical Environment ◽  
Medical Home ◽  
Patient Centered Care ◽  
Equation Modeling ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Regional Survey ◽  
Rural Residents ◽  
Convenience Sample ◽  
Centered Care

Objectives: This study aims to explore the rural residents’ preferences on various aspects of the patient-centered medical home (PCMH) model and the associated physical environment features. Background: The PCMH model has gained popularity as an innovative care model that intends to improve patient experience and outcomes while reducing costs. Yet few studies focused on patients’ perspective, even less considered the needs of the rural communities. Method: Using a convenience sample, an exploratory survey was completed by 362 rural residents in the Midwestern region. Survey items were designed to gather information on both rural residents’ preferences for five key PCMH attributes (comprehensive, patient-centered, coordinated, accessible, and quality) and of the physical environment that supports these attributes. Analyses were arranged along these key attributes. Results: Results indicated that residents’ demographics affect their preferences for spatial features for PCMH. The three most important environmental factors for PCMH for the rural residents are the privacy, extra chairs in the exam room for family, and space that supports information sharing and communication among patient, family, and healthcare staff. Through structural equation modeling analysis, residents’ preferences on comprehensive care, patient-centered care, coordinated care, quality, and safety have shown to affect their preference for the space features. The open-ended survey shows that rural residents are mostly satisfied with their current healthcare environment in terms of supporting patient-centered care, while other aspects still have room for future improvement. Conclusions: Overall, this exploratory study identified important attributes of the physical environment that can support PCMH from rural residents’ perspective.

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