Achieving excellence in community health centers: implications for health reform.
BACKGROUND
Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs.


METHODS
Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance.


RESULTS
Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity.


CONCLUSIONS
In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.
Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA 01545, USA. Deborah.Gurewich@umassmed.edu
Deborah
D
Gurewich
John
J
Capitman
Jenna
J
Sirkin
Diana
D
Traje
D002140:California; D003151:Community Health Centers / Q000458:organization & administration* / Q000592:standards*; D017598:Efficiency, Organizational; D017048:Health Care Costs; D018166:Health Care Reform; D006801:Humans; D008404:Massachusetts; D019982:Organizational Case Studies; D036301:Qualitative Research; D011787:Quality of Health Care; D013781:Texas