Multimethod Evaluation of the VA's Peer-to-Peer Toolkit for Patient-Centered Medical Home Implementation

被引：19
作者：
Luck, Jeff [1 ,2 ]
Bowman, Candice [2 ]
York, Laura [2 ]
Midboe, Amanda [3 ]
Taylor, Thomas [3 ]
Gale, Randall [3 ]
Asch, Steven [3 ,4 ]
机构：
[1] Oregon State Univ, Coll Publ Hlth & Human Sci, Corvallis, OR 97331 USA
[2] VA Greater Los Angeles Healthcare Syst, Ctr Study Healthcare Provider Behav, Los Angeles, CA USA
[3] VA Palo Alto Hlth Care Syst, Ctr Hlth Care Evaluat, Menlo Pk, CA USA
[4] Stanford Univ, Div Gen Med Disciplines, Palo Alto, CA 94304 USA
来源：
JOURNAL OF GENERAL INTERNAL MEDICINE | 2014年 / 29卷
关键词：
primary care redesign; patient-centered care; evaluation; implementation research; quality improvement; HEALTH;
D O I：
10.1007/s11606-013-2738-0
中图分类号：
R19 [保健组织与事业（卫生事业管理）];
学科分类号：
摘要：
Effective implementation of the patient-centered medical home (PCMH) in primary care practices requires training and other resources, such as online toolkits, to share strategies and materials. The Veterans Health Administration (VA) developed an online Toolkit of user-sourced tools to support teams implementing its Patient Aligned Care Team (PACT) medical home model. To present findings from an evaluation of the PACT Toolkit, including use, variation across facilities, effect of social marketing, and factors influencing use. The Toolkit is an online repository of ready-to-use tools created by VA clinic staff that physicians, nurses, and other team members may share, download, and adopt in order to more effectively implement PCMH principles and improve local performance on VA metrics. Multimethod evaluation using: (1) website usage analytics, (2) an online survey of the PACT community of practice's use of the Toolkit, and (3) key informant interviews. Survey respondents were PACT team members and coaches (n = 544) at 136 VA facilities. Interview respondents were Toolkit users and non-users (n = 32). For survey data, multivariable logistic models were used to predict Toolkit awareness and use. Interviews and open-text survey comments were coded using a "common themes" framework. The Consolidated Framework for Implementation Research (CFIR) guided data collection and analyses. The Toolkit was used by 6,745 staff in the first 19 months of availability. Among members of the target audience, 80 % had heard of the Toolkit, and of those, 70 % had visited the website. Tools had been implemented at 65 % of facilities. Qualitative findings revealed a range of user perspectives from enthusiastic support to lack of sufficient time to browse the Toolkit. An online Toolkit to support PCMH implementation was used at VA facilities nationwide. Other complex health care organizations may benefit from adopting similar online peer-to-peer resource libraries.
引用
收藏
页码：572 / 578
页数：7
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