¶ … Strategic Planning May Successfully Aid the Patient-Centered Medical Home Model's Implementation and Value to Our Health Care System How Using Strategic Planning May Successfully Aid the Patient-Centered Medical Home Model's Implementation and Value to Our Health Care System

In 1967, the AAP (American Academy of Pediatrics) introduced the concept of Medical Homes. These homes were at first assigned for obtaining children's medical records. Several decades later in 2002, the Academy expanded its policy statement on the concept, making it more comprehensive, accessible, compassionate and culturally-effective. The new policy also changed the focus of medical home from the child to the family. The ACP (American College of Physicians) and the AAFP (American Academy of Family Physicians) have also developed their own patient-care models which they refer to as "advanced medical home" and "medical home," respectively (PCPCC, 2007).

Many health care experts agree that the basic components of medical home definition include accessibility, teamwork, comprehensive care, patient-centered care and a focus on safety and quality. The medical home model is now accepted universally as a framework for how primary care ought to be structured and delivered. Some have described the medical home concept as a philosophy of care delivery that allows physicians and other HCPs (Health Care Providers) to meet clients and patients at their resident location. Medical homes have become places where patients are treated with compassion, respect and dignity. This enables building strong relationships based on mutual respect between the patient and the providers. Though, initially, some individuals did think of Medical Homes as final destinations or resting places, the homes have improved to the extent that they are now considered a framework for efficient primary care where patients can get the right care at the right time. In recognition of the important role played by medical homes in the provision of health care, the major American physician associations jointly developed and published Joint Principles of the Patient-Centered Medical Home. This jointly released framework has been revised and is now referred to as the PCPCC (PCPCC, 2015).

The medical home concept has the power of transforming how health care is delivered in the United States. Using data from many different medical homes in the country, the AHRQ (Agency for Healthcare Research and Quality) described medical homes as a concept for the structuring and delivering of important functions of primary care. As stated earlier, primary care medical homes have five unique characteristics:

(1) They offer comprehensive care

Many medical homes are responsible for providing almost all of their clients' mental and physical medical needs, including the chronic care, acute care, wellness, and preventative services. For a medical home to effectively offer comprehensive care there is a need for a multidisciplinary team of care providers. Such a team may include medical doctors, care coordinators, educators, social workers, nutritionists, pharmacists, nurses, physician assistants, and nursing practitioners. Even though medical homes may employ huge teams to provide the best and most comprehensive care in their target market, many more practices have formed virtual (contractual) teams and they can possibly combine efforts any time so as to offer their clients the right care at the right time and at comparatively lower costs.

(2) Patient-centered

Many medical homes provide care focused on the whole person. Such care is often based on strong working relationships with patients based on giving the patient respect and dignity. It has been shown that partnering with Medical home clients and their loved ones entails the comprehension and respect for the special preferences, values, culture, needs and beliefs of every individual patient. Medical homes also actively support their clients in trying to organize and manage their personal care at the level of that the clients choose. In recognition of the fact that both patients and their loved ones are core members of the care team, the medical home concept guarantees that they be fully informed in coming up with care plans.

(3) Coordinated care

The medical home model ensures that all aspects of the general healthcare system including community support, home healthcare, medical facilities (hospital care), and specialty care are coordinated. Such coordination is important for continuity in care during transitions between different health care sites such as when patients are discharged from hospitals. The Medical home model also advocates for the building of open and clear communication channels between patients, the care team, the patient's family and the medical home.

(4) Accessible Services

Medical homes have been known to provide more accessible services for individuals with urgent needs including phone access to selected members of the care team, 24/7 telephone access to the home, increased in-person hours and alternative...

Simply put Medical Home practices are highly responsive to their clients' preferences regarding how they want to access their care providers.
(5) Quality and Safety

Medical home practices are often committed to ensuring that they provide the best quality services. Many such institutions have continuous quality improvement initiatives that use tools such as clinical decision-support tools and evidence-based care to help in their interactions with patients and their families. For instance, many medical home practices have been known to carry out performance measurement surveys and conduct other forms of performance-evaluation so as to get know their clients' experiences and level of satisfaction. Some practices even go ahead to publicly share their safety data and quality improvement measures. Such homes are often regarded as the practices which are most committed to quality and safety (AHRQ, n.d.).

A. Strategies leaders may utilize to ensure their organizations achieve primary care medical home transformation

They create and manage system-level objectives at the executive level. Moreover, they develop practical and realistic plans of how they aim to attain their system-level objectives and run these strategies from the very top. Thereafter, they direct leadership focus to system-level enhancements: transparency, leadership systems and personal leadership. Plus, they incorporate the input of both the patients and their families in the improvement plan. In addition, they make their CFOs (Chief financial officers) their quality champions and engage the medical doctors and other providers. They do so in order to build their organizations' capability for improvement

They establish regular improvement meetings highlighting their progress and challenges being faced. Moreover, they ensure that their organizations have data reporting capabilities so as to assess if their changes in progress are having any effect in transforming health care provision. They then use data to report their successes and then continue to push for transformations in their organizations. Publishing reports will have to take into account the different needs of the audiences for whom the data is intended. Knowing the audience and helping them understand what is happening can help increase the impact of transformation projects.

What is even more important is that leaders ought to encourage their followers to continuously improve and innovate to transform their medical homes. Thus, to be successful in managing medical homes there is a need to be a visionary and a motivational person who can help his or her staff to move collaboratively towards the desired performance and service-provision levels (SNMHI, 2010).

Start with a Team

The leaders ought to start assembling their Primary Care Medical Home teams immediately. The ability to put together a good team composed of a CCQO (chief compliance and quality officer), CMO (chief medical officer), CFO (chief financial officer), COO (chief operating officer), deputy COO, practice managers and the CEO (chief executive officer). The team ought to immediately start transforming their practice if they are to meet CMS benchmark.

Commitment

Commitment is much more than just making declarations of loyalty. Commitments have to be shown in the drafting of strategic plans through allocation of funds to improvement projects, for instance, a more promising show of commitment would be the drawing of profit-sharing plans based on quality performance indicators. For instance, such a plan could reward workers for meeting certain patient care milestones. This would not only ensure that quality is improved throughout the practice's services but it will also ensure that workers are motivated to contribute more in their day-to-day activities.

Electronic Health Record

One of the best ways to improve performance is training workers in the use of EHR (Electronic Health Records). Moreover, buying the CCMR (Care Coordination Medical Record) system, which is a form of electronic health record, can also improve performance. The CCMR can not only increase documentation efficiency, but also reduce data redundancy. Once a leader explains why buying such a system / module would be important and when everyone start seeing improvements in their work processes, then providers will definitely join in and start using the systems to help improve care delivery.

Staff Engagement and Buy-In

Getting staff-buy in is important, particularly when making changes in primary care medical homes. Convincing them to come onboard and work together in the implementation of transformation projects plays a key role in determining whether or not a transformation process will succeed.

Comprehensive and Seamless Service Coordination

To enhance the provision of health care, it is important for the service providers to offer an all-round care package. Care providers from different disciplines have to be hired or contacted to be on…