Improving Primary Care: Strategies and Tools for a Better Practice

by Bodenheimer, Thomas; Grumbach, Kevin

• ISBN13: 9780071447386
• ISBN10: 0071447385
• Edition: 1st
• Format: Paperback
• Copyright: 2006-09-15
• Publisher: McGraw-Hill Education / Medical

Summary

The authors of the world's best-selling health policy text offer valuable insights and guidance to primary care practitioners Practice Improvement: The Primary Care Source Book offers frank appraisals and concrete recommendations for primary care practitioners on how to meet the huge, stress-inducing, challenges that they face on a daily basis. The authors offer innovative approaches and suggestions to dealing with primary care issues ranging from the latest electronic technologies to non-traditional options for the patient-physician encounter.

Author Biography

Thomas S. Bodenheimer, MD, MPH, Clinical Professor, Department of Family & Community Medicine, University of California.

Kevin Grumbach, MD, Professor & Chair, Department of Family & Community Medicine, University of California.

Table of Contents

Preface
Acknowledgments

CHAPTER ONE

The Primary Care Home

The Primary Care Home
What is Primary Care?
Why Primary Care?
The Value of a Primary Care Home
The Endangered Primary Care Home
Can Primary Care Fulfill its Vision?
Putting the Primary Care House in Order

CHAPTER TWO

A New Practice Model for Primary Care

Building the New Practice Model
Is the New Practice Model Feasible?

CHAPTER THREE

Patient-Centered Care: Finding the Balance

What is Patient-Centered Care?
Patient-Centered Care in the Patient-Clinician Encounter
Patient-Centered Care in the Primary Care Microsystem
Patient-Centered Care in the Health Care Macrosystem
Patient-Centered Care Meets Cultural Competence
Barriers to Patient-Centered Care
Conclusion: Patient-Centered Care is a Partnership

CHAPTER FOUR

Improving Primary Care for Patients with Chronic Illness

The Chronic Care Model
Implementing the Chronic Care Model
Do Chronic Care Model Components Improve Clinical Outcomes?
Does the Chronic Care Model Save Money?
Changing Primary Care to Incorporate the Chronic Care Model
Conclusion

CHAPTER FIVE

Self-Management Support for People with Chronic Illness

Traditional Versus Collaborative Relationships
Implementing Self-management Support in Clinical Practice: the 5 A’s
Conclusion

CHAPTER SIX

Improving Timely Access to Primary Care

Three Access Models for Primary Care
Case Studies of Advanced Access
Research on Advanced Access
Confronting Problems
How to Begin

CHAPTER SEVEN

Alternatives to the 15-minute Visit

Group Visits
Virtual Encounters
Conclusion

CHAPTER EIGHT

Computerizing the Primary Care Home

The Roles of Electronic Health Care
Techies and Luddites
The Benefits of Computerization
Conclusion

CHAPTER NINE

Health Care Teams in Primary Care

Groups and Teams
A Brief History of Primary Care Teams in the United States
Two Contemporary Primary Care Teams
Building Teams
Research Studies on Primary Care Teams
The Problems with Teams
Introducing Teams into Primary Care

CHAPTER TEN

Diagnosing and Treating the Primary Care Practice

What is a Microsystem?
Diagnosing the Primary Care Microsystem
Treating the Primary Care Microsystem
Conclusion

CHAPTER ELEVEN

Payment for Primary Care

The Primary Care Specialty Income Gap
The Key Role of Volume
Fee-for-Service Payment and the New Practice Model
What Could be done to Change the Situation?

CHAPTER TWELVE

Conclusion

APPENDIX A

Some Organizations and Resources Demonstrating Innovative Primary Care Practices

APPENDIX B

Assessing your Practice

APPENDIX C

Diagnosing Problems in your Practice

APPENDIX D

Primary Care Patient Survey

APPENDIX E

Primary Care Staff Satisfaction Survey

APPENDIX F

Resources on Cultural Competence Health Literacy

APPENDIX G

Office Visit Cycle Time

APPENDIX H

Interruptions in the Day’s Work

APPENDIX I

Group Visit Starter Kit

APPENDIX J

Resources Available from Improving Chronic Illness Care

APPENDIX K

Patient Assessment of Chronic Care

APPENDIX L

Self-management Support Tools

APPENDIX M

Self-management Support Assessment

APPENDIX N

Review of Evidence on the Chronic Care Model

APPENDIX O

Review of Evidence on Primary Care Teams Index