Evaluating A Patient-Centered Medical Home from the Patient’s Perspective

1. Evaluating A Patient-Centered Medical Homefrom the Patient’s Perspective Betty M. Kennedy, PhD Community Outreach Specialist

2. Co-Authors • Sarah Moody-Thomas, PhD • Peter T. Katzmarzyk, PhD • Ronald Horswell, PhD • Willene P. Griffin, MSW, LCSW • Mary T. Coleman, MD, PhD • Jane Herwehe, MPH • Kathleen H. Willis, MD • Jay A. Besse, BS

3. Background The medical home is an organizational approach to improve care, improve patient experience, and reduce medical costs. The patient-centered medical home seeks to address some of the widely recognized inadequacies of primary care delivery by facilitating partnerships among the patient, physician, and healthcare team.1,2 1Berckelaer et al. J Am Board Fam Med. 2012;25:192-198. 2American Academy of Family Physicians 2007: www.acponline.org

4. Purpose The purpose of this qualitative project was to receive input from patients to improve their experiences within the medical home for ongoing disease management and health improvement, and to obtain their recommendations for the most effective methods to involve patients in shaping system policies, procedures and practices consistent with patient and family-centered care principles.

5. Methods A sample of 32 adult patients participated in cognitive interviews (n = 15) and structured focus groups (n = 17) using the Nominal Group Technique (NGT). Exit surveys collected demographic information and input from patients about opportunities for their involvement in shaping medical homes.

6. Results • Both cognitive interviews and NGT sessions revealed patient-perceived strengths and inadequacies within the medical home. Better access to care including more efficient times for patients to schedule appointments, and reduced wait time to see a physician once patients arrive for scheduled appointments were perceived as needing improvements. • Despite inadequacies, equally as important were positive perceptions patients noted about how this medical home helps them reach their health goals, how concerned physicians and nurses are about providing them with high quality healthcare, and satisfaction overall with the care they receive within this clinic.

7. Conclusion Cognitive interviewing, structured focus groups, and exit surveys with patients can be used to identify needed improvements in moving a healthcare system to be more responsive to patients’ preferences, needs, and values.

8. Acknowledgements Thanks to all LSU HCSD clinics, faculty, staff, and others involved for supporting this qualitative work within LSU medical homes. [Ongoing] Special thanks to all Medical Home sites and patients within the medical home for participating in this quality improvement project. [Ongoing] This work was supported by Louisiana State University’s Improving Clinical Outcomes Network (LSU ICON).

9. Community Outreach Core ServicesExamples include:Focus groups, mini seminars & workshops Patient recruitment of high risk sub-groups

10. Questions?