"In Principle We Have Agreement, But in Practice It Is a Bit More Difficult": Obtaining Organizational Buy-In to Patient-Centered Medical Home Transformation. (May 2017)

• Record Type: Journal Article
• Authors: Applequist, Janelle; Miller-Day, Michelle; Cronholm, Peter F.; Gabbay, Robert A.; Bowen, Deborah S.
• Is Part Of: Qualitative health research. Volume 27:Number 6(2017)
• Page Start: 909
• Page End: 922
• Publication Date: 2017-05
• Subjects: behavior change -- group interaction -- health care -- health care -- managed -- health care -- teamwork; Health -- Periodicals; Health behavior -- Periodicals; Health -- Research -- Methodology -- Periodicals; Health behavior -- Research -- Methodology -- Periodicals; 610.7205
• DOI: 10.1177/1049732316680601
• Languages: English
• ISSNs: 1049-7323

Abstract

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis revealed three overarching themes: (a) communication among staff that is open, consistent; (b) implementation of reinforcement techniques; and (c) access to a change implementer who encourages successful evolution. Discussion of these themes provides recommendations for communication approaches to organizational buy-in for medical practices hoping to become a PCMH.