Abstract
BackgroundLarge scale implementation of new strategies and healthcare delivery standards in academic medical centers (AMCs) requires training of healthcare workforce at different stages of their medical career. The patient-centered medical home (PCMH) model for healthcare delivery involves adoption by all members of the healthcare workforce, including seasoned professionals and trainees. Though widely known, the PCMH model has been implemented sporadically at large AMCs and methods to implement the model across healthcare workforce have not been well-documented.MethodsTo meet all PCMH standards and achieve sustainable level 3 recognition, the authors implemented in 2014–2015 a multi-pronged approach that capitalized on existing educational infrastructure among faculty, residents, and medical students. Within 18 months, the authors applied new interdisciplinary practices and policies, redesigned residency training in continuity practices and extensively modified medical school curricula.ResultsThese innovative transformational education efforts addressed the six PCMH standards for faculty, residents, and undergraduate medical students. Faculty played a major role as system change agents and facilitators of learning. Residents learned to better understand patients’ cultural needs, identify ‘at-risk’ patients, ensure continuity of care, and assess and improve quality of care. Medical students were exposed to PCMH core standards throughout their training via simulations, training in the community and with patients, and evaluation tasks. By implementing these changes across the healthcare workforce, the AMC achieved PCMH status in a short time, changed practice culture and improved care for patients and the community. Since then, the AMC has been able to maintain PCMH recognition annually with minimal effort.ConclusionsSuccessful strategies that capitalize on existing strengths in infrastructure complemented by innovative educational offerings and inter-professional partnerships can be adapted by other organizations pursuing similar transformation efforts. This widespread transformation across the healthcare workforce facilitate a deep-rooted change that enabled our academic medical center to sustain PCMH recognition.
Highlights
Large scale implementation of new strategies and healthcare delivery standards in academic medical centers (AMCs) requires training of healthcare workforce at different stages of their medical career
The development and conceptualization of the medical home came from the field of pediatrics through work sponsored by the American Academy of Pediatrics and the Maternal and Child Health Bureau [5]
In this paper we describe our institution’s practice transformation educational efforts to integrate the patientcentered medical home (PCMH) model and its principles into medical education across three key groups comprising the AMC physician workforce– medical students, residents, and faculty
Summary
Large scale implementation of new strategies and healthcare delivery standards in academic medical centers (AMCs) requires training of healthcare workforce at different stages of their medical career. The National Committee for Quality Assurance (NCQA) promulgated and codified these concepts and core principles into a set of standards that are evaluated to award PCMH recognition to practices, which enables collection of enhanced reimbursements from some public and private payors [6]. These incentives have spurred a variety of innovations in graduate and undergraduate medical education– predominantly in the fields of Family Medicine and Internal Medicine [3, 7]—but little has been done for faculty. In this paper we describe our institution’s practice transformation educational efforts to integrate the PCMH model and its principles into medical education across three key groups comprising the AMC physician workforce– medical students, residents, and faculty
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