RT Journal Article
SR Electronic
T1 Organizational Factors Associated with Guideline Concordance of Chronic Disease Care and Management Practices
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 1128
OP 1142
DO 10.3122/jabfm.2022.210502R2
VO 35
IS 6
A1 Deborah J. Cohen
A1 Tamar Wyte-Lake
A1 Pamela Bonsu
A1 Stephanie L. Albert
A1 Lorraine Kwok
A1 Margaret M. Paul
A1 Ann M. Nguyen
A1 Carolyn A. Berry
A1 Donna R. Shelley
YR 2022
UL http://www.jabfm.org/content/35/6/1128.abstract
AB Background: Guidelines for managing and preventing chronic disease tend to be well-known. Yet, translation of this evidence into practice is inconsistent. We identify a combination of factors that are connected to guideline concordant delivery of evidence-informed chronic disease care in primary care.Methods: Cross-sectional observational study; purposively selected 22 practices to vary on size, ownership and geographic location, using National Quality Forum metrics to ensure practices had a ≥ 70% quality level for at least 2 of the following: aspirin use in high-risk individuals, blood pressure control, cholesterol and diabetes management. Interviewed 2 professionals (eg, medical director, practice manager) per practice (n = 44) to understand staffing and clinical operations. Analyzed data using an iterative and inductive approach.Results: Community Health Centers (CHCs) employed interdisciplinary clinical teams that included a variety of professionals as compared with hospital-health systems (HHS) and clinician-owned practices. Despite this difference, practice members consistently reported a number of functions that may be connected to clinical chronic care quality, including: having engaged leadership; a culture of teamwork; engaging in team-based care; using data to inform quality improvement; empaneling patients; and managing the care of patient panels, with a focus on continuity and comprehensiveness, as well as having a commitment to the community.Conclusions: There are mutable organizational attributes connected-guideline concordant chronic disease care in primary care. Research and policy reform are needed to promote and study how to achieve widespread adoption of these functions and organizational attributes that may be central to achieving equity and improving chronic disease prevention.