Innovation in Patient-Centered Care: Lessons from a Qualitative Study of Innovative Health Care Organizations in Washington State

Details

• Personal Author:
  Conrad DA ; Hernandez SE ; Marcus-Smith M ; Reed P ; Watts C
• Description:
  Background: Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations - from strategic planning to goal selection to implementation to maintenance. Methods: We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results: Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions: Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets and addressing conditions for innovation. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Health Care Facilities Workforce And Services Occupational Health Safety
• Keywords:
  Author Keywords: Patient-centered Care Health Care Health Care Reform Health Services Medical Care Policy Primary Care
• ISSN:
  1471-2296
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 1 ; OSHA Region 10 ; OSHA Region 3 ; Vermont ; Virginia ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  13
• NIOSHTIC Number:
  nn:20057134
• Citation:
  BMC Fam Pract 2012 Dec; 13:120
• Contact Point Address:
  Douglas A Conrad, Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195-7660, USA
• Email:
  dconrad@uw.edu
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  BMC Family Practice
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a7713a759c39acc1a0cbb96ee5f640009acfa4472046f0e62a4a95e89fb5412d25e9ff5f9545ec874e8235f67dc6d55507c0df1c530096ba40c0bd2f3ab76136
• Download URL:
  https://stacks.cdc.gov/view/cdc/214578/cdc_214578_DS1.pdf
• File Type:
  [PDF - 347.95 KB ]