Implementing an advanced team-based care model in a federally qualified health center (FQHC): Assessing implementation facilitators and challenges.

Autor: Patel AK; Near North Health, Chicago, IL, USA., Stiehl E; University of Illinois Chicago School of Public Health, Chicago, IL, USA. Electronic address: estiehl@uic.edu., Siegel N; University of Illinois Chicago School of Public Health, Chicago, IL, USA., Panzer J; Tapestry 360 Health, Chicago, IL, USA., Edmiston C; University of Illinois Chicago School of Public Health, Chicago, IL, USA., Deis E; Pillars Community Health, Chicago, IL, USA., Cliff BQ; University of Chicago, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: Preventive medicine [Prev Med] 2024 Aug; Vol. 185, pp. 108044. Date of Electronic Publication: 2024 Jun 20.
DOI: 10.1016/j.ypmed.2024.108044
Abstrakt: Objective: The objective of this paper is to assess implementation facilitators and challenges for advanced team-based care (aTBC) in a federally qualified health center (FQHC). In aTBC, care team coordinators room patients, perform vitals and agenda setting during patient intake, and remain present alongside providers during patient visits.
Methods: The authors conducted a qualitative post-hoc analysis of the aTBC implementation using data from several sources. They used content analysis to code items as facilitators or challenges and thematic analysis to group those into larger themes. Finally, they applied a priori codes from the revised consolidated framework for implementation research (CFIR) to organize the facilitators and barriers into subdomains.
Results: The existing evidence-base around aTBC, the FQHC's ability to pilot and adapt it, and strong implementation leads were key facilitating factors. Challenges included an external shock (i.e., the COVID-19 pandemic), aTBC complexity, and uncertainty about whether success required implementation of the full model versus easier-to-integrate smaller components.
Conclusions: FQHCs that wish to implement aTBC models need strong champions and internal structures for piloting, adapting, and disseminating interventions. FQHC leaders must think strategically about how to build support and demonstrate success to improve an FQHC's chances of expanding and sustaining aTBC.
Competing Interests: Declaration of competing interest Three of the co-authors worked for Tapestry 360, although two have since left the organization. The remaining authors have no financial interests/personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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