Developing a toolkit for panel management

Improving hypertension and smoking cessation outcomes in primary care at the VA

Stella M. Savarimuthu, Ashley E. Jensen, Antoinette Schoenthaler, Anne Dembitzer, Craig Tenner, Colleen Gillespie, Mark D. Schwartz, Scott Sherman

    Research output: Contribution to journalArticle

    Abstract

    Background: As primary care practices evolve into medical homes, there is an increasing need for effective models to shift from visit-based to population-based strategies for care. However, most medical teams lack tools and training to manage panels of patients. As part of a study comparing different approaches to panel management at the Manhattan and Brooklyn campuses of the VA New York Harbor Healthcare System, we created a toolkit of strategies that non-clinician panel management assistants (PMAs) can use to enhance panel-wide outcomes in smoking cessation and hypertension. Methods. We created the toolkit using: 1) literature review and consultation with outside experts, 2) key informant interviews with staff identified using snowball sampling, 3) pilot testing for feasibility and acceptability, and 4) further revision based on a survey of primary care providers and nurses. These steps resulted in progressively refined strategies for the PMAs to support the primary care team. Results: Literature review and expert consultation resulted in an extensive list of potentially useful strategies. Key informant interviews and staff surveys identified several areas of need for assistance, including help to manage the most challenging patients, providing care outside of the visit, connecting patients with existing resources, and providing additional patient education. The strategies identified were then grouped into 5 areas - continuous connection to care, education and connection to clinical resources, targeted behavior change counseling, adherence support, and patients with special needs. Conclusions: Although panel management is a central aspect of patient-centered medical homes, providers and health care systems have little guidance or evidence as to how teams should accomplish this objective. We created a toolkit to help PMAs support the clinical care team for patients with hypertension or tobacco use. This toolkit development process could readily be adapted to other behaviors or conditions. Trial registration. ClinicalTrials.gov, NCT01677533.

    Original languageEnglish (US)
    Article number176
    JournalBMC Family Practice
    Volume14
    DOIs
    StatePublished - Nov 21 2013

    Fingerprint

    Smoking Cessation
    Primary Health Care
    Patient-Centered Care
    Hypertension
    Referral and Consultation
    Interviews
    Delivery of Health Care
    Patient Care Team
    Tobacco Use
    Patient Education
    Patient Compliance
    Home Care Services
    Counseling
    Patient Care
    Nurses
    Education
    Population
    Surveys and Questionnaires

    Keywords

    • Hypertension
    • Panel management
    • Prevention
    • Primary care
    • Smoking cessation

    ASJC Scopus subject areas

    • Family Practice

    Cite this

    Savarimuthu, S. M., Jensen, A. E., Schoenthaler, A., Dembitzer, A., Tenner, C., Gillespie, C., ... Sherman, S. (2013). Developing a toolkit for panel management: Improving hypertension and smoking cessation outcomes in primary care at the VA. BMC Family Practice, 14, [176]. https://doi.org/10.1186/1471-2296-14-176

    Developing a toolkit for panel management : Improving hypertension and smoking cessation outcomes in primary care at the VA. / Savarimuthu, Stella M.; Jensen, Ashley E.; Schoenthaler, Antoinette; Dembitzer, Anne; Tenner, Craig; Gillespie, Colleen; Schwartz, Mark D.; Sherman, Scott.

    In: BMC Family Practice, Vol. 14, 176, 21.11.2013.

    Research output: Contribution to journalArticle

    Savarimuthu, SM, Jensen, AE, Schoenthaler, A, Dembitzer, A, Tenner, C, Gillespie, C, Schwartz, MD & Sherman, S 2013, 'Developing a toolkit for panel management: Improving hypertension and smoking cessation outcomes in primary care at the VA', BMC Family Practice, vol. 14, 176. https://doi.org/10.1186/1471-2296-14-176
    Savarimuthu, Stella M. ; Jensen, Ashley E. ; Schoenthaler, Antoinette ; Dembitzer, Anne ; Tenner, Craig ; Gillespie, Colleen ; Schwartz, Mark D. ; Sherman, Scott. / Developing a toolkit for panel management : Improving hypertension and smoking cessation outcomes in primary care at the VA. In: BMC Family Practice. 2013 ; Vol. 14.
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