Characteristics of Organizational Resources and Supports for Self Management in Primary Care

Shetty, Gowri; Brownson, Carol A.

doi:10.1177/0145721707304171

Cited by 13 publications

(38 citation statements)

References 27 publications

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“…Use of multidisciplinary care teams was strongly associated with delivery of self-management support, consistent with previous analyses of organizational features of care that predict delivery of such support. 29 In addition, our analyses suggest that improving delivery of self-management support may require unique activities for individual chronic conditions, as there was little correlation detected between self-management support scores for these conditions within medical groups.…”

Section: Discussionmentioning

confidence: 78%

Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care

Sequist

Glahn

et al. 2009

J GEN INTERN MED

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Section: Discussionmentioning

confidence: 78%

Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care

Sequist

Glahn

et al. 2009

J GEN INTERN MED

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“…48,53 For example, the Enhancing Practice, Improving Care study found that practice facilitation using a continuous quality improvement approach was effective at improving measures of diabetes care. 51 Likewise, Shetty et al 55 examined the components of organizational support for SMS in primary care practices. These researchers found 8 essential elements of organizational support, including ongoing quality "The team already has many of the attitudes and skills (follow up calls to check on action plan progress, etc.)…”

Section: Repelling Factors Pushing Against Sms Transformationmentioning

confidence: 99%

Practice Characteristics Associated with Better Implementation of Patient Self-Management Support

et al. 2019

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Background: Advanced primary care models emphasize patient-centered care, including self-management support (SMS). This study aimed to promote the translation of SMS into primary care practices and reported on key baseline practice characteristics that may impact SMS implementation.Methods: Thirty-six practices in Colorado and California participated in the study from December 2013 to March 2017. Practice administrators completed a Practice Information Form describing practice characteristics. Clinicians and staff (n ‫؍‬ 716) completed the Practice Culture Assessment and the Patient-Centered Medical Home (PCMH) Monitor. Descriptive statistics were computed to determine practice characteristics related to culture, quality improvement, level of PCMH, and SMS implementation. Field notes and key informant interviews provided contextual details about practices. Iterative qualitative analyses identified important facilitators and barriers and change capabilities around SMS implementation. Results: In bivariate analyses, rural locations, fewer uncontrolled patients with diabetes, higher Medicaid or uninsured populations, underserved designation, and higher level of "PCMHness" were associated with greater reported implementation of patient SMS (all P < .05) at baseline. In the final multilevel model, specialty (FM vs mixed, P ‫؍‬ .0081), rural location (P ‫؍‬ .0109), and higher percent Medicaid (P < .0001) were associated with greater SMS. Practices described key facilitators (alignment, motivation, a visible champion, supporting infrastructure, and functional quality improvement and care teams) and barriers (no shared vision, no visible champion, siloed infrastructure, competing programs, turnover, and time constraints) to improving SMS delivery. Conclusions: Careful attention-and action-on key practice characteristics and context may create more favorable initial conditions for practice change efforts to improve SMS in primary care practices. (J Am Board Fam Med 2019;32:329 -340.) Most patients with type 2 diabetes mellitus (T2DM) in the United States receive diabetes care in primary care settings, which are undergoing rapid transformations due to the need to improve quality and decrease costs. The Patient-Centered Medical Home (PCMH) and the Chronic Care Model are complementary clinical intervention frameworks that are commonly used to support This article was externally peer reviewed. DesignCTH is a 3-arm, cluster-randomized trial to evaluate the reach, effectiveness, adoption, implementation, and maintenance of CTH for patients with 330 The details of change process capability varied widely across the 36 practices; however, there were consistent concepts that emerged about characteristics that propel implementation-supporting infrastructure, functional teams, and practice stability-and those that repel implementation-siloed infrastructure, communication issues, turnover, competing programs, and time/resource constraints. Propelling and repelling factors for change process capabilities are described in Table 5.Poten...

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“…The programs and their achievements are described in detail on the Diabetes Initiative Web site (http://diabetesinitiative.org) and in numerous journal articles, [10][11][12][13][14][15][16] including a special supplement to The Diabetes Educator. [17][18][19][20][21][22][23][24][25][26][27][28][29][30] Six of the 14 projects funded through this initiative focused on improving self-management supports in primary care settings. Their projects began with a 15-month planning phase, during which they tested innovative approaches to reaching and engaging their respective patient populations in self-management.…”

Section: Program Description Implementation Settingsmentioning

confidence: 99%

Cost-effectiveness of Diabetes Self-management Programs in Community Primary Care Settings

et al. 2009

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Characteristics of Organizational Resources and Supports for Self Management in Primary Care

Cited by 13 publications

References 27 publications

Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care

Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care

Practice Characteristics Associated with Better Implementation of Patient Self-Management Support

Cost-effectiveness of Diabetes Self-management Programs in Community Primary Care Settings

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