2014 News & Events

PCT-LEAP featured in RWJF Human Capital Blog
The MacColl LEAP team is working on the online primary care Guide set for for release this fall.  The Robert Wood Johnson Foundation recently featured "The Role of Primary Care Providers in Changing the Culture of Care in Communities" in its online blog.

ACIC-P now available to measure care in correctional healthcare systems
The absence of a validated instrument to direct quality improvement efforts in correctional healthcare systems provided the motivation for Emily Wang, MD, MAS and her team at Yale University to adapt the Assessment of Chronic Illness Care (ACIC). The Assessing Chronic Illness Care- Prison instrument (ACIC-P) was adapted from the original instrument through cognitive interviews of correctional healthcare providers for use in prison systems. ACIC-P assesses how well prison healthcare systems are providing chronic illness care in each of the six components of the Chronic Care Model and includes unique questions on discharge planning and the role of correctional officers in the delivery of care.

The team at Yale has administered the ACIC-P in two prison healthcare systems and are currently analyzing the results of that survey.

Blood pressure control study shows promise in measuring CCM effect on patient blood pressure outcomes
An analysis published in March 2014 examines the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension.   The intervention was delivered over a secure patient website, and used the PACIC survey to assess overall fidelity to the Chronic Care Model.

“Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis” found that web-based pharmacist case management improved blood pressure  control .  The improved outcomes  were accounted for in part through home blood pressure monitoring, e-communication with providers and associated medication intensification, with the entire effect accounted for through communications outside the office via secure messaging.

 “We wanted to see if patients’ perceptions of their care matched the elements of the Chronic Care Model”, explains Group Health Research Institute Associate Investigator and study lead author James Ralston, MD MPH.  “This study demonstrates the sensitivity to change of the PACIC instrument in an intervention using the Chronic Care Model.”

Assessing Patient and Practice Member Perspectives When Evaluating Quality
After the Chronic Care Model has been implemented, is it possible to compare patient and provider team views on quality of care?  A new study provides the first published report exploring this question by administering the Assessment of Chronic Illness Care (ACIC) and Patient Assessment of Chronic Illness Care (PACIC) scales in 39 primary care settings.

Health care settings where elements of the Chronic Care Model have been implemented are likely to have prepared, proactive practice teams, and informed, engaged patients who become active members of their health care teams and accept shared responsibility for their chronic illness care.  However, little is known as to whether primary care teams’ perceptions of how well they have implemented the CCM corresponds with their patients’ own experience of chronic illness care.  Improving patient experiences of care is a priority within the National Quality Strategy as reflected in recent multi-payer initiatives that include the use of patient experience results in determining provider payment

Commenting on "Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis", co-author Michael Parchman said:  “We did this study to see if patients’ experiences of chronic illness care align with what clinicians and staff say about the type of chronic illness care they are able to deliver.”

Study findings show the ACIC and PACIC provide complementary but relatively unique assessments of how well clinical services are aligned with the CCM.

March 2014 presentation:  The Future of Primary Care
“Quality improvement is not a project, it is an approach to how you do your work, and it is either continuous or not at all...we need to reestablish primary care as the foundation of American health care."  - Ed Wagner

On March 10th, MacColl Director Emeritus Ed Wagner delivered a keynote address at the 15th Annual International Summit on Improving Patient Care in the Office Practice and the Community in Washington, DC.  Tune into this archived video not only to enjoy Ed's keen sense of humor but for updates about what we're learning right now from front-line primary care practitioners through our PCT-LEAP national project.

  • View "The Future of Primary Care" on the Institute for Healthcare Improvement's IHI TV website (log-in required).