What Is Patient Safety In The Medical Home?

• PI:                Sydney Dy, MD, MSc; co-Investigator Christina Yuan, PhD, MPH
• Funder:       Agency for Healthcare Research and Quality (AHRQ)
• Status:         Ongoing

In this mixed-methods study collaborating with the National Committee on Quality Assurance (NCQA), we will evaluate how patient-centered medical homes (PCMH) are addressing ambulatory safety across four key domains through data from multiple perspectives, including patient input. Our specific aims are: (1) Using data on practices that have achieved NCQA recognition and providers that have participated in electronic health record meaningful use reporting, explore trends and variation in adoption of patient safety activities based on practice and regional characteristics; (2) using triangulated data from interviews, observation, and patient focus groups, analyze how the PCMH model interacts with patient safety from different perspectives-patient, provider, and administrator - across the four key ambulatory safety domains; and (3) in a sample of practices implementing the PCMH in diverse ways, evaluate the association of contextual issues (eg, practice type) and specific PCMH implementation practices with patient safety measures across the four key domains of ambulatory safety using qualitative comparative analysis.

The expected outcomes will be important findings about how the PCMH and specific implementation elements interact with patient safety and potentially impact safety outcomes, across diverse ambulatory safety domains and PCMH programs. The results will inform public and private sector efforts to advance ambulatory safety, provide critical information on viability of various methods for evaluating ambulatory safety outcomes and suggest ways to better integrate safety into models such as the PCMH.