000000470 001__ 470 000000470 005__ 20260410124447.0 000000470 0247_ $$2DOI$$a10.6083/M44F1NPR 000000470 037__ $$aETD 000000470 245__ $$aBarriers, successes, and provider productivity in a medical home demonstration project in two Portland-area safety net clinics 000000470 260__ $$bOregon Health and Science University 000000470 269__ $$a2008 000000470 336__ $$aThesis 000000470 502__ $$bM.P.H. 000000470 520__ $$an 2007 CareOregon implemented a medical home demonstration project called Primary Care Renewal (PCR) in several Portland-area safety-net clinics. The PCR intervention consists of six components: patient-centered care, team care delivery, proactive panel management, open access scheduling, integrated behavioral health, and intentional evaluation and change using PDSA cycles. This mixed-methods study used quantitative methods to evaluate the effect of PCR on provider productivity and qualitative methods to evaluate barriers and successes in implementation of PCR in two family medicine clinics. Pre- and post-intervention panel data was used to create multivariable models analyzing the effect of PCR on total monthly patients seen and total monthly relative value units accumulated by each provider (n=8). This quantitative analysis found that PCR was associated with a non-significant increase in the productivity of the two pilot providers (visits/month p-value=0.458, RVUs/month p-value=0.075). PCR was associated with a downward trend in productivity for six later starting providers (visits/month p-value=0.901, RVUs/month p-value=0.307). Each care team participated in a group interview to discuss barriers and successes in implementing the six components of PCR. This qualitative analysis found distinct differences among the care teams, specifically differences in team knowledge, support, leadership, and teamwork. These findings indicate that a team with these qualities can succeed both in implementing all the PCR components and increasing productivity. 000000470 540__ $$fCC BY 000000470 542__ $$fIn copyright - single owner 000000470 650__ $$aAmbulatory Care Facilities$$014523 000000470 650__ $$aPatient-Centered Care$$031106 000000470 650__ $$aPolymerase Chain Reaction$$028906 000000470 650__ $$aPrimary Health Care$$024590 000000470 651__ $$aOregon--Portland$$041692 000000470 691__ $$aSchool of Medicine$$041369 000000470 692__ $$aDepartment of Public Health and Preventive Medicine$$041444 000000470 7001_ $$aChoate, Mimi$$uOregon Health and Science University$$041354 000000470 8564_ $$9916e8fdd-61cc-4a65-b10f-c6364ba2091c$$s479121$$uhttps://digitalcollections.ohsu.edu/record/470/files/471_etd.pdf$$ePublic$$2a262cb075a5ff799719cbf2c59242d3b$$31 000000470 901__ $$a<p>These documents are archival records. They are retained for historical reference only. </p><p><b>Need an accessible version? Use the ‘Get Accessible Copy’ link above.</b></p> 000000470 905__ $$a/rest/prod/qn/59/q4/01/qn59q401h 000000470 909CO $$ooai:digitalcollections.ohsu.edu:470$$pstudent-work 000000470 956__ $$aGet Accessible Copy$$uhttps://ohsu.libwizard.com/f/requestaccessibledocument 000000470 980__ $$aTheses and Dissertations