Background And Objectives: The patient-centered medical home (PCMH) is a practice model that is intended to improve the quality of care by making it safer, more comprehensive, integrated, and personal. However, most family medicine residency programs are not fully prepared to train residents on this idealized model. The Colorado Family Medicine Residency PCMH Project's overall objective is to transform 10 residency practices into PCMHs through practice improvement and curriculum redesign. This paper focuses on the programs' implementation of key PCMH components into the residency curricula and the impact on resident self-perceived competence in and use of PCMH components.
Methods: Mixed-method evaluation assessed PCMH curricular characteristics, routine use of PCMH components in patient care, and perceived resident competence after implementation of quality improvement coaching and PCMH curriculum tools. Baseline and follow-up PCMH semi-structured curriculum interviews assessed elements included in the residency programs' curricula. The PCMH Clinician Assessment (PCMH-CA) Survey assessed routine use of PCMH components in patient care. The PCMH Competency Self-Assessment Survey assessed residents' perceived competency in applying PCMH elements in patient care.
Results: Qualitative data results demonstrated active efforts by the residency programs to implement key PCMH components. Survey results showed significant improvement from baseline to follow-up (12--36 months).
Conclusions: Implementation of the key components of PCMH into practice improvement efforts and residency curricula improved residents' routine use of PCMH in patient care and their perceived PCMH competence.
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J Eval Clin Pract
February 2025
The Institute for Urban Indigenous Health Ltd, Windsor, Queensland, Australia.
Rationale: The Patient-Centred Medical Home (PCMH) is a model of team-based care that is patient centred, coordinated, accessible, and focused on quality and safety. To learn how this model of healthcare works in an Indigenous primary health care setting in Australia, we explored the experiences of health staff in an urban Aboriginal Community Controlled Health Service (ACCHS) transitioning to an adapted model of a PCMH. Normalisation Process Theory (NPT) was applied to better understand factors enabling and inhibiting implementation of the PCMH, and the work required to deliver it.
View Article and Find Full Text PDFArch Biochem Biophys
November 2024
Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy. Electronic address:
The vanillyl alcohol oxidase/p-cresol methylhydroxylase (VAO/PCMH) flavoprotein family comprises a broad spectrum of enzymes capable of catalyzing the oxidative bioconversions of various substrates. Among them, pinoresinol hydroxylase (PinH) from the 4-alkylphenol oxidizing subgroup initiates the oxidative degradation of (+)-pinoresinol, a lignan important for both lignin structure and plant defense. In this study, we present a detailed biochemical and structural characterization of PinH from Pseudomonas sp.
View Article and Find Full Text PDFBMC Pediatr
November 2024
Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, 295 Chipeta Way, Williams Building, Room 1N410, Salt Lake City, UT, 84108, USA.
Background: Vision screening as part of well-child visits is recommended annually for US children 3 to 6 years. However, 63% of children do not get a vision screening in well-child visits. The Patient-Centered Medical Home (PCMH) improves the receipt of preventive care visits in other medical specialties but it is unknown if it improves receipt of vision screening.
View Article and Find Full Text PDFBMJ Open
November 2024
Department of Medicine, Weill Cornell Medicine, New York, New York, USA.
Background And Objectives: Receiving care at patient-centred medical homes (PCMH) is associated with reduced emergency department (ED) visits among children. Adverse social determinants of health (SDoH), such as lower socioeconomic status and household poverty, are associated with increased ED visits in children. The objective of this study is to use machine learning techniques to understand the relative importance of each PCMH component among different populations with adverse SDoH on the outcome of ED visits.
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