Coach medical home: A curriculum to facilitate patient-centered medical home transformation

In an effort to improve patient care, retain excellent primary care providers, and control costs, primary care practices across the United States and the world are transforming to patient-centered medical homes (PCMH). This is no small task. PCMH redesign requires changes to almost every process and system in a primary care practice in order to put patients at the center of care, from improving phone access to collecting and monitoring data for population based care and redesigning referral systems with hospitals and specialists. So how do busy practices do this? Practice facilitation (coaching) and learning communities are two proven methods practices can use as they pursue the culture and system changes necessary for the long-term transformation inherent in successful medical home implementation.

To enhance the skills and knowledge of practice facilitators and the effectiveness of learning communities, we developed a web-based curriculum called Coach Medical Home. The curriculum consolidates best practice from the Safety Net Medical Home Initiative—a nationwide demonstration program that helped 64 safety-net practices in their transformation to medical homes—as well as evidence from the implementation science literature about how to implement widespread system transformation in a manner that is tailored to local needs. Coach Medical Home includes tools and reference material that practice facilitators can use to support different types of practices as they become medical homes. The topics covered include (1) getting started; (2) understanding payment and recognition; (3) sequencing changes in practice; (4) creating a measurement system for quality improvement; (5) developing effective learning communities and (6) planning for sustainability and spread. The curriculum is based on the conceptual framework of the eight Change Concepts for Practice Transformation that provide an actionable sequence for medical home transformation, emphasizing the importance of engaged leadership and a quality improvement strategy. Coach Medical Home is a helpful tool available in the public domain for domestic and international audiences; further, the process of developing the curriculum may be helpful for others designing web-based technical assistance resources for large-scale transformation initiatives.