title: Turning on the care coordination switch in rural primary care: voices from the practices--clinician champions, clinician partners, administrators, and nurse care managers.
abstract: This study sought to understand the acceptability and feasibility of office-based nurse care management in medium to large rural primary care practices. A qualitative assessment of Care Management Plus (a focused medical home model for complex patients) implementation was conducted using semistructured interviews with 4 staff cohorts. Cohorts included clinician champions, clinician partners, practice administrators, and nurse care managers. Seven key implementation attributes were: a proven care coordination program; adequate staffing; practice buy-in; adequate time; measurement; practice facilitation; and functional information technology. Although staff was positive about the care coordination concept, model acceptability was varied and additional study is required to determine sustainability.
authors.affiliation: Oregon Rural Practice-based Research Network, Department of Family Medicine, Oregon Clinical & Translational Science Institute, Oregon Health & Science University, Portland, OR 97239, USA. fagnanl@ohsu.edu
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Fagnan
authors.forename: David A
authors.initials: DA
authors.lastname: Dorr
authors.forename: Melinda
authors.initials: M
authors.lastname: Davis
authors.forename: Paul
authors.initials: P
authors.lastname: McGinnis
authors.forename: Jo
authors.initials: J
authors.lastname: Mahler
authors.forename: Molly McCarthy
authors.initials: MM
authors.lastname: King
authors.forename: LeAnn
authors.initials: L
authors.lastname: Michaels
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D006270:Health Facility Administrators; D006801:Humans; D008297:Male; D008491:Medical Informatics Applications; D008875:Middle Aged; D009718:Nurse Administrators; D009732:Nursing Care / Q000458:organization & administration; D009922:Oregon; D009936:Organizational Innovation; D010346:Patient Care Management / Q000458:organization & administration*; D010348:Patient Care Team; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration*; D055815:Young Adult