Implementation of Women's Health Patient Aligned Care Teams

Summary

VA has undertaken a major initiative to transform care through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home (PCMH) concept, PACT aims to improve access, continuity, coordination and comprehensiveness using team-based care that is patient-driven and patient-centered. However, how VA should adapt PACT to meet the needs of special populations, such as women Veterans, is yet to be worked out. The main goal of this study was to develop and test an evidence-based quality improvement (EBQI) approach to adapting and implementing PACT for women Veterans, incorporating comprehensive women's health care in gender-sensitive care environments, thereby accelerating achievement of PACT tenets for women Veterans and reducing persistent gender disparities in VA quality of care.

Conditions

• Patient-centered Medical Home Implementation

Interventions

OTHER

Multilevel stakeholder engagement

Structured, in-person stakeholder panel meeting of VA network, VA medical center, and primary care and women's health leaders using modified Delphi panel techniques to come to consensus on a quality improvement (QI) roadmap within each participating VA network, followed by intermittent progress reporting and post-24 months in-person capstone stakeholder panel meetings

OTHER

Quality improvement (QI) education/training

Initial in-person and ongoing virtual team training in QI principles, methods, and project proposal development and refinement

OTHER

Technical support

Research team provided technical review of and feedback on local QI project proposals, helped develop and/or recommend process/outcome measures, identified and shared relevant published literature (e.g., measures, interventions), and provided general technical support (e.g., how to analyze local data, how to conduct a local focus group)

OTHER

Formative feedback

Research team provided aggregated all-site and local data from baseline patient and provider/staff surveys, 12-month patient surveys, and other data and findings to local teams for ongoing and new QI project idea development

OTHER

External practice facilitation

Within and across site calls with local teams to review progress, identify needs, help solve problems, discuss current and new projects, as well as potential for spread

OTHER

National policy guidance

VA Handbooks on policy and practice for PACT implementation guidance and on delivery of comprehensive women's health services disseminated to all VA facilities

Sponsors & Collaborators

• University of California, Los Angeles

  collaborator OTHER

• RAND

  collaborator OTHER

• VA Office of Research and Development

  lead FED

Principal Investigators

• Elizabeth M. Yano, PhD MSPH · VA Greater Los Angeles Healthcare System, Sepulveda, CA

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-05-09

Primary Completion

2017-09-30

Completion

2018-09-30

Countries

• United States

Study Locations