期刊
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
卷 18, 期 21, 页码 -出版社
MDPI
DOI: 10.3390/ijerph182111160
关键词
Patient-Centered Medical Home; primary care; innovation; implementation; complex needs; adoption; assimilation
资金
- GERIATRIC EDUCATION AND RESEARCH INSTITUTE, SINGAPORE
This study examined the implementation of PCMH in Singapore, highlighting challenges in adopting and assimilating innovations that require time, leadership, and effective communication.
Patient-Centered Medical Home (PCMH) has been found to improve care for complex needs patients in some countries but has not yet been widely adopted in Singapore. This study explored the ground-up implementation of a PCMH in Singapore by describing change strategies and unpacking initial experience and perception. In-depth interviews were conducted for twenty-two key informants from three groups: the implementers, their implementation partners, and other providers. Diffusion of innovations emerged as an overarching theory to contextualize PCMH in its early implementation. Three core innovations differentiated the PCMH from usual primary care: (i) team-based and integrated care; (ii) empanelment; and (iii) shared care with other general practitioners. Change strategies employed to implement these innovations included repurposing pre-existing resources, building a partnership to create supporting infrastructure and pathways in the delivery system, and doing targeted outreach to introduce the PCMH. Initial experience and perception were characterized by processes to adopt and assimilate the innovations, which were identified as challenging due to less predictable, self-organizing behaviors by multiple players. To work with the inherent complexity and novelty of the innovations, time, leadership, standardized methods, direct communication, and awareness-building efforts are needed. This study was retrospectively registered (Protocol ID: NCT04594967).
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据