Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State
<p>Abstract</p> <p>Background</p> <p>Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-12-01
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| Series: | BMC Family Practice |
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| Online Access: | http://www.biomedcentral.com/1471-2296/13/120 |
| _version_ | 1828311493275287552 |
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| author | Reed Peter Conrad Douglas A Hernandez Susan E Watts Carolyn Marcus-Smith Miriam |
| author_facet | Reed Peter Conrad Douglas A Hernandez Susan E Watts Carolyn Marcus-Smith Miriam |
| author_sort | Reed Peter |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance.</p> <p>Methods</p> <p>We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus.</p> <p>Results</p> <p>Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation.</p> <p>Conclusions</p> <p>Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets and addressing conditions for innovation.</p> |
| first_indexed | 2024-04-13T15:59:34Z |
| format | Article |
| id | doaj.art-8143c8a7997a401784f01dc5b40d60bd |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-13T15:59:34Z |
| publishDate | 2012-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-8143c8a7997a401784f01dc5b40d60bd2022-12-22T02:40:35ZengBMCBMC Family Practice1471-22962012-12-0113112010.1186/1471-2296-13-120Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington StateReed PeterConrad Douglas AHernandez Susan EWatts CarolynMarcus-Smith Miriam<p>Abstract</p> <p>Background</p> <p>Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance.</p> <p>Methods</p> <p>We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus.</p> <p>Results</p> <p>Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation.</p> <p>Conclusions</p> <p>Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets and addressing conditions for innovation.</p>http://www.biomedcentral.com/1471-2296/13/120Patient-centered carePrimary careHealth care reform |
| spellingShingle | Reed Peter Conrad Douglas A Hernandez Susan E Watts Carolyn Marcus-Smith Miriam Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State BMC Family Practice Patient-centered care Primary care Health care reform |
| title | Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State |
| title_full | Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State |
| title_fullStr | Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State |
| title_full_unstemmed | Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State |
| title_short | Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State |
| title_sort | innovation in patient centered care lessons from a qualitative study of innovative health care organizations in washington state |
| topic | Patient-centered care Primary care Health care reform |
| url | http://www.biomedcentral.com/1471-2296/13/120 |
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