How Does the Culture of Medical Group Practices Influence the Types of Programs Used to Assure Quality of Care?

How Eight Primary Care Practices Initiated and Maintained Quality Monitoring and Reporting

“…Comparison practices were selected from different states, and the comparison data were collected several years before ours; therefore, we cannot rule out the possibility that regional differences and/or secular trends may be present. In addition, the comparison practices in both the studies by Ohman-Strickland et al 17 and Kaissi et al 18 most likely were not entirely representative of primary care practices. However, any bias in selection would have likely made the comparison practices more like the "early adopters" we studied; so, the observation of differences between our practices and the comparison practices is likely to underestimate differences between primary care practices overall.…”

“…All subscales are means with a range from 1 to 5. 17 Five subscales from the Culture of Group Practices instrument of Kaissi et al 18 were administered to providers only (ie, physicians, nurse practitioners, and physician assistants): information emphasis (4 items), quality emphasis (6 items), business emphasis (4 items), innovativeness (3 items), and provider autonomy (3 items). Each was reported as a mean, ranging from 1 ϭ not at all to 4 ϭ to a great extent.…”

“…Each was reported as a mean, ranging from 1 ϭ not at all to 4 ϭ to a great extent. 18 To provide a comparison with our study results, we utilized published data from 51 family practices in New Jersey and eastern Pennsylvania reported by OhmanStrickland et al 17 and from 88 primary care group practices in North Dakota, South Dakota, and Wisconsin reported by Kaissi et al 18 Data Analysis Quantitative data were analyzed using software from the Statistical Analysis System, version 9.1 (SAS Institute, Cary, NC). Means and standard deviations were calculated and, when appropriate, differences in means were evaluated between study practices and more representative samples from the literature using the standard t test.…”

Teamwork and Delegation in Medical Homes: Primary Care Staff Perspectives in the Veterans Health Administration

“…Change initiatives that rely on team-based task delegation but fail to provide sufficient resources to support team functioning are unlikely to be successful when it comes to full and sustained implementation. 32,33 Our cross-lab analysis of interviews with members of VHA pilot teams resulted in development of a framework to describe resources that must be in place to support team formation, successful team functioning, and initiation and sustainment of within-team delegation-all of which are key to PCMH implementation. In the current paper, we report on team-level resources.…”

Practice Context Affects Efforts to Improve Diabetes Care for Primary Care Patients: A Pragmatic Cluster Randomized Trial

“…[9][10][11] The considerable heterogeneity in outcomes of practice-focused interventions suggests that practice context, such as structural and demographic features and practice culture, may influence successful program implementation. 4,9,[12][13][14][15][16][17][18][19][20] However, studies of primary care practices rarely follow up primary analyses with careful examination of how practice context interacts with intervention approaches to affect outcomes.…”