title: Evaluation of PCMH Model Adoption on Teamwork and Impact on Patient Access and Safety.
abstract: OBJECTIVE
  Each of the participating patient-centered medical home (PCMH) received coaching and participated in learning collaborative for improving teamwork. The objective of the study was to assess the impact of trainings on patient-centered teamwork.
  
  
  METHODS
  The Teamwork Perception Questionnaire (TPQ) was administered once in spring 2014 and then in fall 2015. The TPQ consists of 35 questions across 5 domains: mutual support, situation monitoring, communication, team structure, and leadership. Based on our objective we compared the frequencies of strongly agree/agree by domain. The difference was tested using chi-square test. We compared the scores on each domain (strongly agree/agree = 1; maximum score = 7) via Wilcoxon rank sum test.
  
  
  RESULTS
  The response rate for this survey was n = 29 (80.6%) in spring 2014, and n = 31 (86.1%) in fall 2015. We found that the practice members significantly ( P < .05) strongly agreed/agreed more in fall 2015 than spring 2014 for characteristics-"staff relay relevant information in a timely manner" (64.5% vs 83.9%) and "staff follow a standardized method of sharing information when handing off patients" (67.7% vs 90.3%) under communication domain and for characteristic-"staff within my practice share information that enables timely decision making" (74.2% vs 90.3%). However, there was no statistical significant difference observed in the scores for the overall TPQ at the 2 time points.
  
  
  CONCLUSIONS
  Despite the statistical insignificance, the observations in PCMHs across the spectrum of practices participating in the Maryland Multi-Payer Program demonstrated enhanced teamwork specifically in communication and in leadership. This we believe will continue to result in enhanced patient access to care and safety.
authors.affiliation: 1 University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Niharika
authors.initials: N
authors.lastname: Khanna
authors.affiliation: 2 University of Maryland School of Pharmacy, Baltimore, MD, USA.
authors.forename: Fadia T
authors.initials: FT
authors.lastname: Shaya
authors.affiliation: 2 University of Maryland School of Pharmacy, Baltimore, MD, USA.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Gaitonde
authors.affiliation: 3 Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Abiamiri
authors.affiliation: 4 Maryland Health Care Commission, DHMH Baltimore, MD, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Steffen
authors.affiliation: 4 Maryland Health Care Commission, DHMH Baltimore, MD, USA.
authors.forename: David
authors.initials: D
authors.lastname: Sharp
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration; D006282:Health Personnel / Q000193:education*; D006297:Health Services Accessibility; D006801:Humans; D007318:Inservice Training; D007857:Leadership; D008396:Maryland; D010348:Patient Care Team; D061214:Patient Safety; D018802:Patient-Centered Care; D011795:Surveys and Questionnaires
keywords: patient access to care and safety; patient care team; patient-centered medical home (PCMH); primary health care; quality of health care; teamwork