As physician practices embark on the journey to transform to Patient-Centered Medical Homes (PCMH), questions that are often in the forefront if the “transformation” team’s mind is how are “we” going to get there, and more importantly, what is it going to take for the team to get there?  These can be very daunting questions and concepts. However, positive reflection and encouragement can be gleaned in the fact that the practice has made a commitment to begin the journey and are in essence starting to peel back the layers of the onion to better understand the true nuts and bolts of managing the art of quality driven patient-centered care.  Throughout the transformation journey, a practice may find themselves finding opportunities to improve processes, and even perhaps, being in a situation where they are validating the evidence of processes, policies, procedures and workflows which they have had in place.  Whether it be (deleted that) the practice is discovering multiple “aha” moments while validating and celebrating their commitment to quality driven patient care, or uncovering new opportunities to improve delivery of patient care, (deleted these) both are key and essential components of the transformation journey. This journey can take weeks and even months, and should always be considered an evolving process that never comes to a close.

questions about pcmh

The critical question to a practice’s overall success is “how has the work which was done through the transformation journey prepared them for long-term sustainability and compliance?

The first and foremost important component of sustainability is a continuing commitment from the entire practice team, including leadership, and most importantly the providers.  The overall communication with employees of the operational support and passion for the new model of quality driven patient-centered care will guide the entire team to ongoing long-term sustainability and success.

In order maintain the momentum, it is imperative that physician practices continue to use and apply actionable reports to assess and measure evidence of clinical quality measures as well as service quality measures. The findings from reports should be assessed (at minimum annually) to determine if clinical and service outreaches are yielding positive/negative results and what actions need to be taken.  Most importantly these findings need to be shared with practice staff at regular team meetings and used to develop and/or modify measurable goals based upon outcomes.  Further, outreaches should be completed on an annual basis at the very minimum.  All team members should share the responsibility of developing attainable improvement goals and tracking progress against these goals.

The practice’s policies should be reviewed continuously and based on the established review date which is stated in the policy.  The policies should also contain periodic audits or “spot checks” verifying continuing compliance with PCMH standards.  Additional training and written plans of correction should be developed for less than satisfactory compliance.  As appropriate, all members of the practice care team should be involved in developing corrective action plans.

Additionally, the practice should always take the time to celebrate success – both big and the small.  Employees will feel more engaged and energized to maintain the culture of competence, passion and commitment if they see the results of their efforts. If you are interested in learning more about Patient-Centered Medical Homes (PCMH) or need an expert to walk you through the process any answer your questions contact our Director of Healthcare – Practice Transformation, Susan Maxsween at or by calling 1-866-567-5422.