title: Tackling the triple aim in primary care residencies: the I3 POP Collaborative.
abstract: OBJECTIVE
  The I3 POP Collaborative's goal is to improve care of populations served by primary care residencies in North Carolina, South Carolina, and Virginia by dramatically improving patients' experience, quality of care, and cost-effectiveness. We examine residency baseline triple aim measures, compare with national benchmarks, and identify practice characteristics associated with data reporting.
  
  
  METHODS
  We used a cross-sectional design, with 27 primary care residency programs caring for over 300,000 patients. Outcome measures were obtained via data pulls from electronic health records and practice management system submitted by residencies; they include quality measure sets for chronic illness and prevention, patient experience (usual provder continuity and time to third available), and utilization (emergency visits, hospitalizations, referrals, high-end radiology).
  
  
  RESULTS
  Thirteen practices (48%) reported all required baseline measures. We found associations between data reporting ability with registry use (59% versus 0%) and having a faculty member involved in data management (69% versus 29%). Reported measures varied widely; examples include colorectal cancer screening (median: 61%, range: 28%--80%), provider continuity (median: 52%, range: 1%--68%), subspecialty referral rate (median: 24%, range: 10%--51%). Seventy percent of patient-centered medical homes (PCMH) recognized practices had usual provider continuity (UPC) > or = collaborative median versus 0% of non-PCMH recognized practices. Median data were similar to national comparisons for chronic disease measures, lower for prevention and better for utilization.
  
  
  CONCLUSIONS
  Baseline triple aim data are highly variable among residencies, but residency care is comparable to available national standards. Registry use and faculty leadership in data management are critical success factors for assessing practice performance.
authors: Department of Family Medicine, University of North Carolina.
authors: Katrina E
authors: KE
authors: Donahue
authors: Alfred
authors: A
authors: Reid
authors: Ann
authors: A
authors: Lefebvre
authors: Michele
authors: M
authors: Stanek
authors: Warren P
authors: WP
authors: Newton
mesh_terms: D000328:Adult; D019985:Benchmarking; D002648:Child; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005180:Faculty, Medical; D005194:Family Practice / Q000193:education*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000592:standards*; D009657:North Carolina; D010372:Pediatrics / Q000193:education*; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012042:Registries; D013022:South Carolina; D014768:Virginia