Patient-Team Partnership at Small Primary Care Practices Needs Improvement

The level of partnering between clinical teams and patients was only modest in about 200 Colorado and New Mexico practices evaluated from 2015 to 2017, according to a recent article by an AHRQ-funded grantee in the Journal of the American Board of Family Medicine. The study was part of EvidenceNow, an AHRQ initiative to increase the use of evidence and improve care in more than 1,500 small- and medium-sized primary care practices in 12 states. Researchers analyzed surveys from participating practices regarding patient-team partnership activities in an effort to address gaps in partnership strategies. They found that practices with higher levels of patient-team partnership activity were better able to address social needs of their patients, such as engaging patients and families in self-management, linking patients to community resources, soliciting patient input on practice operations and using patient data to inform care delivery. Access the abstract.

2019 Jul-Aug;32(4):490-504. doi: 10.3122/jabfm.2019.04.180361.

Primary Care Practices' Implementation of Patient-Team Partnership: Findings from EvidenceNOW Southwest.

Hall TL1, Knierim KE2, Nease DE Jr2, Staton EW2, Nkouaga C2, Miriam Dickinson L2, Rhyne RL2, Perry Dickinson W2.

Author information

1: From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (TLH, KEK, DEN, EWS, LMD, WPD); Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque (CN); Department of Family & Community Medicine, University of New Mexico, Albuquerque (RLR). tristen.hall@ucdenver.edu.
2: From Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (TLH, KEK, DEN, EWS, LMD, WPD); Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque (CN); Department of Family & Community Medicine, University of New Mexico, Albuquerque (RLR).

Abstract

INTRODUCTION:

Care teams partnering with patients are integral to quality primary care. Effective patient-team partnership recognizes patients' contributions in decision-making and respecting patients' goals and social context. We report practice characteristics associated with greater patient-team partnership scores.

METHODS:

EvidenceNOW Southwest was a multistate initiative to improve cardiovascular care in primary care practices through guideline-concordant aspirin use, blood pressure control, cholesterol management, and smoking cessation. EvidenceNOW Southwest provided 9 months of practice facilitation and information technology support through regular meetings and training to 211 Colorado and New Mexico primary care practices from 2015 to 2017. We analyzed surveys from 97% of participating practices regarding patient-team partnership activities of self-management support, social need assessment, resource linkages, and patient input. We used linear and mixed effects regression modeling to examine relationships between patient-team partnership and practice characteristics.

RESULTS:

Practice characteristics significantly associated with greater patient-team partnership were using patient registries, medically underserved area designation, multispecialty mix, and using clinical cardiovascular disease management guidelines. Our findings suggest that patient-team partnership implementation in small primary care practices is moderate, with mean practice- and member-level scores of 52 of 100 (range, 0-100) and 71 of 100 (range, 10-100), respectively.

CONCLUSION:

Practices can improve efforts to partner with patients to assess social needs, gather meaningful input on practice improvement and patient experience, and offer resource connections. Our findings supplement recent evidence that patient registries and evidence-based guidelines may effectively prevent and manage cardiovascular disease. These strategies may also promote primary care patient-team partnership.

KEYWORDS:

Colorado; Cross-Sectional Studies; New Mexico; Partnership Practice; Patient Care Team; Patient-Centered Care; Primary Health Care; Quality Improvement; Registries; Surveys and Questionnaires