Recommendations for a mixed methods approach to evaluating the Patient-Centered medical home

Roberta E. Goldman, Donna Parker, Joanna Brown, Judith Walker, Charles B. Eaton, Jeffrey M. Borkan

Research output: Contribution to journalArticle

Abstract

PURPOSE There is a strong push in the United States to evaluate whether the patient-centered medical home (PCMH) model produces desired results. The explanatory and contextually based questions of how and why PCMH succeeds in different practice settings are often neglected. We report the development of a comprehensive, mixed qualitative-quantitative evaluation set for researchers, policy makers, and clinician groups. METHODS To develop an evaluation set, the Brown Primary Care Transformation Initiative convened a multidisciplinary group of PCMH experts, reviewed the PCMH literature and evaluation strategies, developed key domains for evaluation, and selected or created methods and measures for inclusion. RESULTS The measures and methods in the evaluation set (survey instruments, PCMH meta-measures, patient outcomes, quality measures, qualitative interviews, participant observation, and process evaluation) are meant to be used together. PCMH evaluation must be sufficiently comprehensive to assess and explain both the context of transformation in different primary care practices and the experiences of diverse stakeholders. In addition to commonly assessed patient outcomes, quality, and cost, it is critical to include PCMH components integral to practice culture transformation: patient and family centeredness, authentic patient activation, mutual trust among practice employees and patients, and transparency, joy, and collaboration in delivering and receiving care in a changing environment. CONCLUSIONS This evaluation set offers a comprehensive methodology to enable understanding of how PCMH transformation occurs in different practice settings. This approach can foster insights about how transformation affects critical outcomes to achieve meaningful, patient-centered, high-quality, and cost-effective sustainable change among diverse primary care practices.

Original languageEnglish (US)
Pages (from-to)168-175
Number of pages8
JournalAnnals of Family Medicine
Volume13
Issue number2
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Keywords

  • Context
  • Evaluation
  • Mixed methods
  • Patient-centered medical home
  • Practice transformation
  • Qualitative methods
  • Quantitative methods

ASJC Scopus subject areas

  • Family Practice

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