Physician satisfaction with chronic care processes: A cluster-randomized trial of guided care

Research output: Contribution to journalArticle

Abstract

PURPOSE Chronically ill older patients with multiple conditions are challenging to care for, and new models of care for this population are needed. This study evaluates the effect of the Guided Care model on primary care physicians' impressions of processes of care for chronically ill older patients.&METHODS: In Guided Care a specially educated registered nurse works at the practice with 2 to 5 primary care physicians, performing 8 clinical activities for 50 to 60 chronically ill older patients. The care model was tested in a cluster-randomized controlled trial between 2006 and 2009. All eligible primary care physicians in 14 pods (teams of physicians and their chronically ill older patients) agreed to participate (n = 49). Pods were randomly assigned to provide either Guided Care or usual care. Physicians were surveyed at baseline and 1 year later. We assessed the effects of Guided Care using responses from 38 physicians who completed both survey questionnaires. We measured physicians' satisfaction with chronic care processes, time spent on chronic care, knowledge of their chronically ill older patients, and care coordination provided by physicians and off ce staff.&RESULTS: Compared with the physicians in the control group, those in the Guided Care group rated their satisfaction with patient/family communication and their knowledge of the clinical characteristics of their chronically ill older patients sig-nif cantly higher (ρ <0.05 in linear regression models). Other differences did not reach statistical signif cance.&CONCLUSIONS: Based on physician report, Guided Care provides important ben-ef ts to physicians by improving communication with chronically ill older patients and their families and in physicians' knowledge of their patients' clinical conditions.

Original languageEnglish (US)
Pages (from-to)308-315
Number of pages8
JournalAnnals of family medicine
Volume8
Issue number4
DOIs
StatePublished - Jan 1 2010

Keywords

  • Chronic care
  • Physician satisfaction;guidedcare
  • Randomized controlled trial

ASJC Scopus subject areas

  • Family Practice

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