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Multimethod Evaluation of the VA’s Peer-to-Peer Toolkit for Patient-Centered Medical Home Implementation

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Title Multimethod Evaluation of the VA’s Peer-to-Peer Toolkit for Patient-Centered Medical Home Implementation
Names Luck, Jeff (creator)
Bowman, Candice (creator)
York, Laura (creator)
Midboe, Amanda (creator)
Taylor, Thomas (creator)
Gale, Randall (creator)
Asch, Steven (creator)
Date Issued 2014-07 (iso8601)
Note To the best of our knowledge, one or more authors of this paper were federal employees when contributing to this work. This is the publisher’s final pdf. The article is copyrighted by the Society of General Internal Medicine and published by Springer. It can be found at: http://link.springer.com/journal/11606.
Abstract BACKGROUND: Effective implementation of the patient-centered medical home (PCMH) in primary care
practices requires training and other resources, such as
online toolkits, to share strategies and materials. The
Veterans Health Administration (VA) developed an online
Toolkit of user-sourced tools to support teams
implementing its Patient Aligned Care Team (PACT)
medical home model.
OBJECTIVE: To present findings from an evaluation of
the PACT Toolkit, including use, variation across facilities,
effect of social marketing, and factors influencing
use.
INNOVATION: The Toolkit is an online repository of
ready-to-use tools created by VA clinic staff that
physicians, nurses, and other team members may
share, download, and adopt in order to more effectively
implement PCMH principles and improve local performance
on VA metrics.
DESIGN: Multimethod evaluation using: (1) website
usage analytics, (2) an online survey of the PACT
community of practice’s use of the Toolkit, and (3) key
informant interviews.
PARTICIPANTS: Survey respondents were PACT team
members and coaches (n=544) at 136 VA facilities.
Interview respondents were Toolkit users and nonusers
(n=32).
MEASURES: For survey data, multivariable logistic
models were used to predict Toolkit awareness and
use. Interviews and open-text survey comments were
coded using a “common themes” framework. The
Consolidated Framework for Implementation Research
(CFIR) guided data collection and analyses.
KEY RESULTS: The Toolkit was used by 6,745 staff in
the first 19 months of availability. Among members of
the target audience, 80% had heard of the Toolkit, and
of those, 70% had visited the website. Tools had been
implemented at 65% of facilities. Qualitative findings
revealed a range of user perspectives from enthusiastic
support to lack of sufficient time to browse the Toolkit.
CONCLUSIONS: An online Toolkit to support PCMH
implementation was used at VA facilities nationwide. Other complex health care organizations may benefit
from adopting similar online peer-to-peer resource
libraries.
Genre Article
Topic primary care redesign
Identifier Luck, J., Bowman, C., York, L., Midboe, A., Taylor, T., Gale, R., & Asch, S. (2014). Multimethod Evaluation of the VA’s Peer-to-Peer Toolkit for Patient-Centered Medical Home Implementation. Journal of General Internal Medicine, 29, 572-578. doi:10.1007/s11606-013-2738-0

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