Measuring the Culture of Medical Group Practices

Kralewski, John E.; Dowd, Bryan E; Kaissi, Amer; Curoe, Ann; Rockwood, Todd

doi:10.1097/00004010-200507000-00002

Cited by 47 publications

(58 citation statements)

References 8 publications

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“…To this end, qualitative work can inform our understanding of and support for improved design of structures and care processes for primary care. Data from clinician and patient surveys linked to claims and electronic health record data can proceed alongside qualitative studies to identify ways of delivering the features of primary care that are cognizant of local culture 141 and population needs, and that also improve patient outcomes.…”

Section: Priorities For Future Data and Researchmentioning

confidence: 99%

Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

et al. 2015

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Primary care plays a central role in the provision of health care, and is an organizing feature for health care delivery systems in most Western industrialized democracies. For a variety of reasons, however, the practice of primary care has been in decline in the U.S. This paper reviews key primary care concepts and their definitions, notes the increasingly complex interplay between primary care and the broader health care system, and offers research priorities to support future measurement, delivery and understanding of the role of primary care features on health care costs and quality.

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Section: Priorities For Future Data and Researchmentioning

confidence: 99%

Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

et al. 2015

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“…De igual forma, el comportamiento de los profesionales (información, empatía, etc.) podría diferir de unas unidades clínicas o especialidades médicas a otras 20 . El análi-sis multinivel tiene en cuenta la posibilidad de que los sucesos no sean independientes calculando de forma apropiada el error estándar cuando la estructura de los datos es jerárquica o anidada 19,21 .…”

Section: Discussionunclassified

“…El uso del análisis multinivel permite la identificación de estas unidades clínicas con menos probabilidades de equivocación que si se emplean otros métodos 17 . Por lo tanto, este tipo de análisis es especialmente útil para llevar a cabo comparaciones entre unidades clínicas [20][21][22][23] . La identificación de las unidades clíni-cas excelentes y de aquéllas con áreas de mejora es especialmente relevante en los casos en los que la organización establezca sistemas de recompensa (incentivos o penalizaciones) basados en la percepción de los pacientes, implante planes de mejora específicos para unidades clínicas en función de dichos resultados, establezca estrategias de benchmarking corporativo, o proporcione esta información a los pacientes quienes podrían incorporarla como un elemento más a la hora de elegir las unidades en las que desean ser atendidos.…”

Section: Discussionunclassified

Análisis de la calidad de la información proporcionada a los pacientes por parte de unidades clínicas especializadas ambulatorias mediante análisis por modelos multinivel

Rodrigo

Viñes²,

Guillén-Grima

2009

Anales Sis San Navarra

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Fundamento. La influencia de la información recibida por los pacientes en su satisfacción es de gran importancia ya que, entre otros aspectos, puede mejorar la adherencia del paciente al tratamiento y contribuir a mejorar su estado de salud.El objetivo del estudio es conocer, a partir de los cuestionarios de satisfacción, qué porcentaje de la variabilidad de la percepción del paciente sobre la información recibida acerca del régimen de vida y los medicamentos se atribuye a los siguientes niveles: paciente, unidad clínica y especialidad; así como identificar las variables que han influido en los resultados. Material y métodos. Se realizaron entrevistas telefóni-cas a 6.922 pacientes atendidos en consultas externas en el Servicio Navarro de Salud en el año 2005 (tasa de respuesta 92,4%). Se ha evaluado si los pacientes habían recibido prescripción farmacológica e información sobre el régimen de vida y, en caso afirmativo, su valoración de la calidad de la mencionada información. Se han analizado 94 unidades clínicas en régimen ambulatorio y 34 especialidades médicas. Se ha realizado un análisis estadístico jerárquico con 3 niveles. resultados. En los ítems estudiados, el porcentaje de la variabilidad explicada por la unidad clínica y la especialidad médica osciló entre 0 y el 12,6% y el explicado por el paciente, entre el 87,4% y el 99,3%. conclusiones. Se ha detectado variabilidad en el comportamiento de las distintas unidades clínicas en relación con la prescripción farmacológica y con la información proporcionada sobre el régimen de vida. No obstante, la mayor parte de la variabilidad se ha localizado en el nivel "paciente". Palabras clave. Satisfacción del paciente. Análisis multinivel. Prescripción farmacológica. Régimen de vida. Unidades clínicas. abstract background. The influence of the information received by patients on their satisfaction is of great importance since, amongst other aspects, it can improve patients' adherence to treatment and contribute to improving their state of health.The study aimed to determine, on the basis of satisfaction questionnaires, the percentage of variability in patients' perception of the information received concerning way of life and medicines, attributed to the following levels: patient, clinical unit and specialisation. It also aimed to identify the variables that influence the results. Material and Methods.Telephone interviews were conducted with 6,922 patients treated in outpatient units in the Navarre Health Service in the year 2005 (rate of reply, 92.4%). An evaluation was made of whether the patients had received medical prescription and information on way of life and, where affirmative, their evaluation of the quality of this information. Ninety-four outpatient clinics and 34 medical specialisations were analysed. A hierarchical statistical analysis at three levels was made.results. In the items studied, the variability explained by clinical unit and medical specialisation oscillated between 0 and 12.6%, and explained by the patient between 87.4 and 99.3%.conclus...

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“…To assess dimensions or components of PCMH model implementation, the questionnaire used constructs drawn from multiple surveys investigating primary care, the medical home, and chronic disease models. 12,[17][18][19][20][21] In developing the questionnaire, we were guided by the conceptual framework of PCMH proposed by Rittenhouse et al 2 In our survey, we measured 6 of the 7 features of PCMH they described: (1) each patient has a personal physician, (2) use of whole-person orientation, (3) use of team-based care, (4) coordination and integration of care across the health system, (5) a focus on quality and safety; and (6) timely access to care and communication.…”

Section: Data Sourcesmentioning

confidence: 99%

Patient-Centered Medical Home Among Small Urban Practices Serving Low-Income and Disadvantaged Patients

Berry

Mijanovich

Albert

et al. 2013

The Annals of Family Medicine

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PURPOSEResearch on the patient-centered medical home (PCMH) model and practice redesign has not focused on the unique challenges and strengths of very small primary care practices serving disadvantaged patient populations. We analyzed the practice characteristics, prior experiences, and dimensions of the PCMH model that exist in such practices participating in the Primary Care Information Project (PCIP) of the New York City Department of Mental Health and Hygiene. METHODSWe obtained descriptive data, focusing on PCMH, for 94 primary care practices with 5 or fewer clinicians serving high volumes of Medicaid and minority patient populations in New York City. Data included information extracted from PCIP administrative data and survey data collected specifi cally for this study.RESULTS Survey results indicated substantial implementation of key aspects of the PCMH among small practices serving disadvantaged patient populations, despite considerable potential challenges to achieving PCMH implementation. Practices tended to use few formal mechanisms, such as formal care teams and designated care or case managers, but there was considerable evidence of use of informal team-based care and care coordination nonetheless. It appears that many of these practices achieved the spirit, if not the letter, of the law in terms of key dimensions of PCMH.CONCLUSIONS Small practices can achieve important aspects of the PCMH model of primary care, often with informal rather than formal mechanisms and strategies. The use of fl exible, less formal strategies is important to keep in mind when considering implementation and assessment of PCMH-like initiatives in small practices.

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Measuring the Culture of Medical Group Practices

Cited by 47 publications

References 8 publications

Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

Análisis de la calidad de la información proporcionada a los pacientes por parte de unidades clínicas especializadas ambulatorias mediante análisis por modelos multinivel

Patient-Centered Medical Home Among Small Urban Practices Serving Low-Income and Disadvantaged Patients

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