Importance of Understand the Population of Patients for Whom the Primary Care Team Is Responsible as a Strategy in Improving the Providing of Health Care and Its Accessbility
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Patients, health plans, employers, and suppliers can hasten the transformation—and all will benefit greatly from doing so. The first step in solving any problem is to define the proper goal. Efforts to reform health care have been hobbled by lack of clarity about the goal, or even by the pursuit of the wrong goal. Narrow goals such as improving access to care, containing costs, and boosting profits have been a distraction. Access to poor care is not the objective, nor is reducing cost at the expense of quality. Increasing profits is today misaligned with the interests of patients, because profits depend on increasing the volume of services, not delivering good results.
To achieve this potential, the transition to team-based primary care requires, for most practices, profound changes in the culture and organization of care, in the nature of interactions among colleagues and with patients, in education and training, and in the ways in which primary care personnel and patients understand their roles and responsibilities. In addition, although team-based care may implicitly be considered patient-centered from the perspective of the health care system—because it is designed to make primary care more comprehensive and accessible, thereby meeting important needs of patients and families—this perception may not be universal. From the perspective of some clinicians and patients, team-based care may feel like a departure from patient-centered care because of its perceived potential to (1) disrupt relationships that are highly valued and seen as the foundation of good care, and (2) splinter care delivery across multiple team members. (Coleman K, Reid R., 2013)
Naylor MD, Coburn KD, Kurtzman ET, et al. Inter-professional team-based primary care for chronically ill adults: state of the science. Unpublished white paper presented at the ABIM Foundation meeting to Advance Team-Based Care for the Chronically Ill in Ambulatory Settings. 2010 March 24-25; Philadelphia, PA.
Mitchell P, Wynia R, Golden B, et al. Core principles and values of effective team-based health care. Discussion Paper. Washington, DC: Institute of Medicine; 2012. https://www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-Values.pdf.
Okun, S, Schoenbaum S, Andrews D, et al. Patients and health care teams forging effective partnerships. Discussion Paper. Washington, DC: Institute of Medicine; 2014. https://www.accp.com/docs/positions/misc/PatientsForgingEffectivePartnerships%20-%20IOM%20discussion%20paper%202014.pdf.
Coleman K, Reid R. Continuous and team-based healing relationships: improving patient care through teams. In: Phillips KE, Weir V, eds. Safety Net Medical Home Initiative Implementation Guide Series. 2nd ed. Seattle, WA: Qualis Health and The MacColl Center for Health Care Innovation at the Group Health Research Institute; 2013.
Shojania KG, Ranji SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA 2006;296(4):427-440.