Writing The New Playbook For U.S. Health Care: Lessons From Wisconsin

Toussaint, John

doi:10.1377/hlthaff.28.5.1343

Cited by 65 publications

(40 citation statements)

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“…Both the NDP and recent literature suggest that transitioning current practice confi gurations into such an integrated PCMH model is daunting. Recent articles 3,5,37,38,[50][51][52][53][54][55][56][57] and books 58,59 on health care redesign provide valuable insights. Our experience in evaluating the NDP and a review of the larger literature lead us to 3 overarching recommendations for moving forward in redesigning primary care and medical neighborhoods.…”

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confidence: 99%

Summary of the National Demonstration Project and Recommendations for the Patient-Centered Medical Home

Crabtree¹,

Nutting²,

Miller³

et al. 2010

The Annals of Family Medicine

207

186

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This article summarizes fi ndings from the National Demonstration Project (NDP) and makes recommendations for policy makers and those implementing patientcentered medical homes (PCMHs) based on these fi ndings and an understanding of diverse efforts to transform primary care.The NDP was launched in June 2006 as the fi rst national test of a particular PCMH model in a diverse sample of 36 family practices, randomized to facilitated or self-directed groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical record audits, and patient and clinical staff surveys. Peerreviewed manuscripts from the NDP provide answers to 4 key questions: (1) Can the NDP model be built? (2) What does it take to build the NDP model? (3) Does the NDP model make a difference in quality of care? and (4) Can the NDP model be widely disseminated?We fi nd that although it is feasible to transform independent practices into the NDP conceptualization of a PCMH, this transformation requires tremendous effort and motivation, and benefi ts from external support. Most practices will need additional resources for this magnitude of transformation.Recommendations focus on the need for the PCMH model to continue to evolve, for delivery system reform, and for suffi cient resources for implementing personal and practice development plans. In the meantime, we fi nd that much can be done before larger health system reform. INTRODUCTIONE merging consensus among policy makers, professional organizations, clinicians, and payers bears witness that health care in the United States has reached a defi ning moment. 1 The landmark 2001 Institute of Medicine report Crossing the Quality Chasm called for extensive overhaul and redesign of US health care.2 The patient-centered medical home (PCMH) is a popular model that proponents hope addresses many of the concerns raised in that report. [3][4][5][6][7] The PCMH concept is endorsed by the major primary care professional organizations, who issued a joint statement on principles of the PCMH in 2007, emphasizing patients' ongoing relationship with a personal physician; team approaches to care; a wholeperson orientation; mechanisms to support care integration, quality, safety and access; and payment for added value. 8 During the past several years, a growing number of PCMH demonstration projects have been undertaken. 9 Some of these focus on chronic care. [9][10][11] Most are regional in scope 9,10,12 or are conducted within a particular integrated health care system. 9,[13][14][15] Relatively few both are comprehensive in scope and include diverse, especially small, independent practices. 9,16 The National Demonstration Project (NDP) launched by the American Academy of Family Physicians (AAFP) S81NDP SU M M A RY A ND R ECO M MENDAT IONS F OR P C MH demonstration project on a national sample of practices designed to test a comprehensive model of the PCMH envisioned by the Future of Family Medicine report. 17In...

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confidence: 99%

Summary of the National Demonstration Project and Recommendations for the Patient-Centered Medical Home

Crabtree¹,

Nutting²,

Miller³

et al. 2010

The Annals of Family Medicine

207

186

View full text Add to dashboard Cite

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“…Since then it has been met with apparent great success in healthcare organisations across the world from hospitals in the USA (Savary and CrawfordMason, 2006), Australia (Bem-Tovim et al, 2007) and the UK Mitchell, 2006, Fillingham, 2007), in both the acute (Radnor et al, 2006;Joosten et al, 2009) and community settings (Grove et al, 2010a, b). For example, Virginia Mason Medical Centre in Seattle created enough capacity through waste reduction to improve patient safety (Furman & Caplan, 2007); costs and quality were the focus at Thedacare in Wisconsin (Toussaint, 2009) and the service capacity was the driver of Lean in mental health in Denver (LaGanga, 2011). The application of Lean is considered necessary to improve clinical processes for the benefit of patients by increasing quality, safety and efficiency (Fillingham, 2007;Silvester et al, 2004;Radnor and Boaden, 2008;Breyfogle and Salveker, 2004).…”

Section: Lean Thinkingmentioning

confidence: 99%

A case study of kanban implementation within the pharmaceutical supply chain

Papalexi

Bamford

Dehe

2015

International Journal of Logistics Research and Applications

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The paper explores the implementation of the kanban system, which is a Lean technique, within the Pharmaceutical Supply Chain (PSC). The case study provides insight to the benefits and challenges arising from the application of this technique, within a group of cooperative pharmacists, in Greece. The research questions developed from the review of the literature were tested using evidence from field-based, action research within a pharmaceutical organisation. The reported case study contributes to the longer term debate on assessing the Lean maturity level within the healthcare sector. There are two primary findings: i) that the adoption of kanban system provides a strategic benefit and improves the quality of services. ii) it also provides a basis for a strategy of operational change; it gives the opportunity to the organisation to move away from the current push delivery and logistics systems toward improved logistics strategy models.

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“…However, the evidence on the potential effectiveness of these approaches in health care is relatively weak 13,18 and consists primarily of single-site studies. [19][20][21] To address this gap in knowledge, we present a new framework and instrument for defining key management dimensions and for measuring them on a large scale in health care organizations. We describe the variation in management practices among a large sample of hospitals; assess its association with processes of care, readmissions, and mortality for patients with acute myocardial infarction (AMI); and suggest specific directions for the testing and dissemination of health care management approaches.…”

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confidence: 99%