Different Paths to High-Quality Care: Three Archetypes of Top-Performing Practice Sites

Authors, Primary Feifer,C.;Nemeth,L.;Nietert,P. J.;Wessell,A. M.;Jenkins,R. G.;Roylance,L.;Ornstein,S. M.
Title Primary Different Paths to High-Quality Care: Three Archetypes of Top-Performing Practice Sites
Periodical Full Annals of Family Medicine
Pub Year 2007
Volume 5
issue Not Available
Start Page 233-241
Abstract PURPOSE: Primary care practices use different approaches in their quest for high-quality care. Previous work in the Practice Partner Research Network (PPRNet) found that improved outcomes are associated with strategies to prioritize performance, involve staff, redesign elements of the delivery system, make patients active partners in guideline adherence, and use tools embedded in the electronic medical record. The aim of this study was to examine variations in the adoption of improvements among sites achieving the best outcomes. METHODS: This study used an observational case study design. A practice-level measure of adherence to clinical guidelines was used to identify the highest performing practices in a network of internal and family medicine practices participating in a national demonstration project. We analyzed qualitative and quantitative information derived from project documents, field notes, and evaluation questionnaires to develop and compare case studies. RESULTS: Nine cases are described. All use many of the same improvement strategies. Differences in the way improvements are organized define 3 distinct archetypes: the Technophiles, the Motivated Team, and the Care Enterprise. There is no single approach that explains the superior performance of high-performing practices, though each has adopted variations of PPRNet's improvement model. CONCLUSIONS: Practices will vary in their path to high-quality care. The archetypes could prove to be a useful guide to other practices selecting an overall quality improvement approach.
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Reference Type(s) Journal Article
Topic Tag(s) Comprehensive Care;System Approach to Quality and Safety;Health Information Technology
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Case Study Yes
Commentary/Opinion Piece No
Historical Publication No
Key/Foundational Article No
Literature Review No
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