The effect of organizational climate on patient-centered medical home implementation.
Organizational climate is a key determinant of successful adoption of innovations; however, its relation to medical home implementation is unknown. This study examined the association between primary care providers' (PCPs') perception of organization climate and medical home implementation in the Veterans Health Administration. Multivariate regression was used to test the hypothesis that organizational climate predicts medical home implementation. This analysis of 191 PCPs found that higher scores in 2 domains of organizational climate (communication and cooperation, and orientation to quality improvement) were associated with a statistically significantly higher percentage (from 7 to 10 percentage points) of PCPs implementing structural changes to support the medical home model. In addition, some aspects of a better organizational climate were associated with improved organizational processes of care, including a higher percentage of patients contacted within 2 days of hospital discharge (by 2 to 3 percentage points) and appointments made within 3 days of a patient request (by 2 percentage points).
VISN 4 Center for Evaluation of PACT, Philadelphia VA Medical Center, Philadelphia, PA Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA Robert Wood Johnson Clinical Scholar Program, University of Pennsylvania, Philadelphia, PA ashokr@upenn.edu.
Ashok
A
Reddy
VISN 4 Center for Evaluation of PACT, Philadelphia VA Medical Center, Philadelphia, PA Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
Judy A
JA
Shea
VISN 4 Center for Evaluation of PACT, Philadelphia VA Medical Center, Philadelphia, PA.
Anne
A
Canamucio
VISN 4 Center for Evaluation of PACT, Philadelphia VA Medical Center, Philadelphia, PA Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
Rachel M
RM
Werner
D005260:Female; D006801:Humans; D008297:Male; D017146:Models, Organizational; D015279:Organizational Culture; D018802:Patient-Centered Care; D011320:Primary Health Care; D012044:Regression Analysis; D014481:United States; D014493:United States Department of Veterans Affairs
medical home; organizational climate; primary care delivery; veterans