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Challenges with Implementing a Patient-Centered Medical Home Model for Women Veterans.
Womens Health Issues. 2017 Mar - Apr; 27(2):214-220.WH

Abstract

BACKGROUND

The Veterans Health Administration (VA) Patient Aligned Care Team (PACT) initiative aims to ensure that all patients receive care consistent with medical home principles. Women veterans' unique care needs and minority status within the VA pose challenges to delivery of equitable, comprehensive primary care for this population. Currently, little is known about whether and/or how PACT should be tailored to better meet women veterans' needs.

METHODS

In 2014, we conducted semistructured interviews with 73 primary care providers and staff to examine facilitators and barriers encountered in providing PACT-principled care to women veterans. Respondents were located in eight VA medical centers in eight different states across the United States.

RESULTS

Respondents perceived PACT as improving continuity of care for patients and as increasing ability of nursing staff to practice at the top of their license. However, the implementation of core medical home features and team huddles was inconsistent and varied both within and across medical centers. Short staffing, inclusion of part-time providers on teams, balancing performance requirements for continuity and same-day access, and space constraints were identified as ongoing barriers to PACT implementation. Challenges unique to care of women veterans included a higher prevalence of psychosocial needs, the need for specialized training of primary care personnel, and short staffing owing to additional sharing of primary care support staff with specialist providers.

CONCLUSION

Providers and staff face unique challenges in delivering comprehensive primary care to women veterans that may require special policy, practice, and management action if benefits of PACT are to be fully realized for this population.

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Authors+Show Affiliations

Chuang E
Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California. Electronic address: emchuang@ucla.edu.
Brunner J
Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California.
Mak S
Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California.
Hamilton AB
HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Health Care System, Los Angeles, California.
Canelo I
HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Health Care System, Los Angeles, California.
Darling J
HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Health Care System, Los Angeles, California.
Rubenstein LV
Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California; HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Health Care System, Los Angeles, California.
Yano EM
Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California; HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Health Care System, Los Angeles, California.

MeSH

Attitude of Health PersonnelContinuity of Patient CareFemaleHumansInterviews as TopicNursesPatient Care TeamPatient-Centered CarePhysicians, Primary CareQualitative ResearchUnited StatesUnited States Department of Veterans AffairsVeteransWomen's Health Services

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28063848

Clinical Trial Links

Implementation of Women's Health Patient Aligned Care Teams

Citation

Chuang, Emmeline, et al. "Challenges With Implementing a Patient-Centered Medical Home Model for Women Veterans." Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 27, no. 2, 2017, pp. 214-220.
Chuang E, Brunner J, Mak S, et al. Challenges with Implementing a Patient-Centered Medical Home Model for Women Veterans. Womens Health Issues. 2017;27(2):214-220.
Chuang, E., Brunner, J., Mak, S., Hamilton, A. B., Canelo, I., Darling, J., Rubenstein, L. V., & Yano, E. M. (2017). Challenges with Implementing a Patient-Centered Medical Home Model for Women Veterans. Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 27(2), 214-220. https://doi.org/10.1016/j.whi.2016.11.005
Chuang E, et al. Challenges With Implementing a Patient-Centered Medical Home Model for Women Veterans. Womens Health Issues. 2017 Mar - Apr;27(2):214-220. PubMed PMID: 28063848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Challenges with Implementing a Patient-Centered Medical Home Model for Women Veterans. AU - Chuang,Emmeline, AU - Brunner,Julian, AU - Mak,Selene, AU - Hamilton,Alison B, AU - Canelo,Ismelda, AU - Darling,Jill, AU - Rubenstein,Lisa V, AU - Yano,Elizabeth M, Y1 - 2017/01/04/ PY - 2016/07/22/received PY - 2016/11/23/revised PY - 2016/11/29/accepted PY - 2017/1/9/pubmed PY - 2017/12/19/medline PY - 2017/1/9/entrez SP - 214 EP - 220 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 27 IS - 2 N2 - BACKGROUND: The Veterans Health Administration (VA) Patient Aligned Care Team (PACT) initiative aims to ensure that all patients receive care consistent with medical home principles. Women veterans' unique care needs and minority status within the VA pose challenges to delivery of equitable, comprehensive primary care for this population. Currently, little is known about whether and/or how PACT should be tailored to better meet women veterans' needs. METHODS: In 2014, we conducted semistructured interviews with 73 primary care providers and staff to examine facilitators and barriers encountered in providing PACT-principled care to women veterans. Respondents were located in eight VA medical centers in eight different states across the United States. RESULTS: Respondents perceived PACT as improving continuity of care for patients and as increasing ability of nursing staff to practice at the top of their license. However, the implementation of core medical home features and team huddles was inconsistent and varied both within and across medical centers. Short staffing, inclusion of part-time providers on teams, balancing performance requirements for continuity and same-day access, and space constraints were identified as ongoing barriers to PACT implementation. Challenges unique to care of women veterans included a higher prevalence of psychosocial needs, the need for specialized training of primary care personnel, and short staffing owing to additional sharing of primary care support staff with specialist providers. CONCLUSION: Providers and staff face unique challenges in delivering comprehensive primary care to women veterans that may require special policy, practice, and management action if benefits of PACT are to be fully realized for this population. SN - 1878-4321 UR - https://www.unboundmedicine.com/medline/citation/28063848/Challenges_with_Implementing_a_Patient_Centered_Medical_Home_Model_for_Women_Veterans_ DB - PRIME DP - Unbound Medicine ER -