Patient-centered medical home (PCMH) transformation requires the visible and sustained engagement and tangible support of a wide range of leaders within the practice. To drive and sustain PCMH transformation, leaders must provide the vision for change, help identify changes to test, and build and sustain the will within the practice for transformation. This implementation guide from the Safety Net Medical Home Initiative provides information and advice for practices undergoing PCMH transformation.
The guide uses the Institute for Healthcare Improvement’s Seven Leadership Leverage Points for Organization-Level Improvement in Health Care framework to explain the arenas in which leaders can most effectively use their time and energies to drive and sustain transformation. These action points are:
- Establish and oversee specific system-level aims at the highest governance level.
- Develop an executable strategy to achieve the system-level aims and oversee their execution at the highest governance level.
- Channel leadership attention to system-level improvement: personal leadership, leadership systems, and transparency.
- Put patients and families on the improvement team.
- Make the Chief Financial Officer a quality champion.
- Engage physicians.
- Build improvement capability.
Elements of engaged leadership described in the guide include:
- Provide visible and sustained leadership to lead overall culture change as well as specific strategies to improve quality and spread and sustain change.
- Establish and support a QI team that meets regularly and guides the effort.
- Ensure that providers and other care team members have protected time to conduct activities beyond direct patient care that are consistent with the medical home model.
- Build the practice’s values on creating a medical home for patients into staff hiring and training processes.
The Safety Net Medical Home Initiative is funded by The Commonwealth Fund and eight other funders, with technical assistance from Qualis Health and the MacColl Institute for Healthcare Innovation at the Group Health Research Institute. The initiative is working with five regional coordinating centers, which are each supporting the implementation of patient-centered medical homes in over a dozen safety net clinics.
Additional resources on this change concept are available from the Safety Net Medical Home Initiative website.
Ignatius Bau 