Ten Common Structures and Processes of High-Performing Primary Care Practices.

Area of Science:

• Primary Care Research
• Health Services Research
• Quality Improvement

Background:

• Structures and processes in healthcare delivery are theorized to influence patient outcomes.
• Decades of primary care research have not definitively linked specific structures/processes to improved patient outcomes.
• Prioritizing implementation of numerous recommended structures/processes remains challenging due to limited evidence.

Purpose of the Study:

• To identify structures and processes frequently observed in high-performing primary care practices.
• To focus on practices excelling in chronic care management and prevention.
• To provide evidence for prioritizing specific interventions in primary care settings.

Main Methods:

• Conducted key informant interviews.
• Sampled 22 high-performing primary care practices nationally.
• Identified commonly present structures and processes.

Main Results:

• Identified 10 structures/processes consistently present in high-performing practices.
• These structures/processes primarily support two functions: patient outreach and gap avoidance.
• Findings highlight key operational elements in successful chronic care management.

Conclusions:

• The identified structures/processes offer a prioritized list for implementation and further research.
• Further investigation is needed to confirm the specific impact of these elements on patient outcomes.
• This study addresses the need for evidence-based prioritization in primary care quality improvement.