title: "In Principle We Have Agreement, But in Practice It Is a Bit More Difficult": Obtaining Organizational Buy-In to Patient-Centered Medical Home Transformation.
abstract: The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis revealed three overarching themes: (a) communication among staff that is open, consistent; (b) implementation of reinforcement techniques; and (c) access to a change implementer who encourages successful evolution. Discussion of these themes provides recommendations for communication approaches to organizational buy-in for medical practices hoping to become a PCMH.
authors.affiliation: 1 University of South Florida, Tampa, Florida, USA.
authors.forename: Janelle
authors.initials: J
authors.lastname: Applequist
authors.affiliation: 2 Chapman University, Orange, California, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Miller-Day
authors.affiliation: 3 University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Cronholm
authors.affiliation: 4 Harvard University, Cambridge, Massachusetts, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gabbay
authors.affiliation: 1 University of South Florida, Tampa, Florida, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Bowen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008873:Mid-Atlantic Region; D008875:Middle Aged; D017146:Models, Organizational; D009936:Organizational Innovation; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*
keywords: behavior change; group interaction; health care; managed; teamwork