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- Date Submitted: 01/01/2015 06:02 AM
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SECTION I: INTRODUCTION
The term “medical home” was first introduced by the American Academy of Pediatrics in 1967. It described a primary healthcare system that encompassed the all the care needs of the patient and family (Arend, Tsang-Quin, Levine, & Thomas, 2012, p. 434; Sia, Tonniges, Osterhus, & Taba, 2004, p. 1473-1474). But, it was not until 2006, almost five decades later, that the Patient-Centered Primary Care Collaborative (PCPCC) started a national movement endorsing patient-centered medical homes. In 2008, the National Committee for Quality Assurance (NCQA), the Joint Commission (TJC), and the Accreditation Association for Ambulatory Health Care (AAAHC) all launched medical home accreditation programs and, in 2009, the Patient Centered Medical Home (PCMH) was identified as the primary care model of the Military Health System (MHS) and the NCQA as the outside accreditation agency (Military Health System Patient Centered Medical Home Guide, 2011, p. 1-7). There were obvious obstacles to PCMH implementation within the MHS. First, the Military Medical Command (MEDCOM) published a detailed PCMH manual that covered elements such as team composition, team member roles, and patient care expectations. But, although MEDCOM provided an implementation timeline, it did not specify how each facility would actually practice as a PCMH. PCMH could not be standardized across the board because available resources varied from hospital to hospital and, because it was not standardized, success was difficult to measure. Another obstacle was staff investment. Military hospital leadership changes frequently and new leadership means new “projects”. It is difficult to get staff to commit to new initiatives when, in two years or less, the initiative historically goes to the wayside. For the Pediatric Clinic at XXX, the transition to PCMH was occurring at the same time that the hospital was “right sizing” and furloughing staff. Civilians were being asked to commit to this...
The term “medical home” was first introduced by the American Academy of Pediatrics in 1967. It described a primary healthcare system that encompassed the all the care needs of the patient and family (Arend, Tsang-Quin, Levine, & Thomas, 2012, p. 434; Sia, Tonniges, Osterhus, & Taba, 2004, p. 1473-1474). But, it was not until 2006, almost five decades later, that the Patient-Centered Primary Care Collaborative (PCPCC) started a national movement endorsing patient-centered medical homes. In 2008, the National Committee for Quality Assurance (NCQA), the Joint Commission (TJC), and the Accreditation Association for Ambulatory Health Care (AAAHC) all launched medical home accreditation programs and, in 2009, the Patient Centered Medical Home (PCMH) was identified as the primary care model of the Military Health System (MHS) and the NCQA as the outside accreditation agency (Military Health System Patient Centered Medical Home Guide, 2011, p. 1-7). There were obvious obstacles to PCMH implementation within the MHS. First, the Military Medical Command (MEDCOM) published a detailed PCMH manual that covered elements such as team composition, team member roles, and patient care expectations. But, although MEDCOM provided an implementation timeline, it did not specify how each facility would actually practice as a PCMH. PCMH could not be standardized across the board because available resources varied from hospital to hospital and, because it was not standardized, success was difficult to measure. Another obstacle was staff investment. Military hospital leadership changes frequently and new leadership means new “projects”. It is difficult to get staff to commit to new initiatives when, in two years or less, the initiative historically goes to the wayside. For the Pediatric Clinic at XXX, the transition to PCMH was occurring at the same time that the hospital was “right sizing” and furloughing staff. Civilians were being asked to commit to this...