Browsing by Author "Woodard, LeChauncy"

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    An evidence-based, structured, expert approach to selecting essential indicators of primary care quality
    (Public Library of Science, 2022) Hysong, Sylvia J.; Arredondo, Kelley; Hughes, Ashley M.; Lester, Houston F.; Oswald, Frederick L.; Petersen, Laura A.; Woodard, LeChauncy; Post, Edward; DePeralta, Shelly; Murphy, Daniel R.; McKnight, Jason; Nelson, Karin; Haidet, Paul
    Background The purpose of this article is to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and (when appropriate) generate new measures of health care quality, using primary care as a case example. Primary health care is central to the health care system and health of the American public; thus, ensuring high quality is essential. Due to its complexity, ensuring high-quality primary care requires measurement frameworks that can assess the quality of the infrastructure, workforce configurations, and processes available. This paper describes the use of the Productivity Measurement and Enhancement System (ProMES) to compile a targeted set of such measures, prioritized according to their contribution and value to primary care. Methods We adapted ProMES to select and rank existing primary care measures according to value to the primary care clinic. Nine subject matter experts (SMEs) consisting of clinicians, hospital leaders and national policymakers participated in facilitated expert elicitation sessions to identify objectives of performance, corresponding measures, and priority rankings. Results The SMEs identified three fundamental objectives: access, patient-health care team partnerships, and technical quality. The SMEs also selected sixteen performance indicators from the 44 pre-vetted, currently existing measures from three different data sources for primary care. One indicator, Team 2-Day Post Discharge Contact Ratio, was selected as an indicator of both team partnerships and technical quality. Indicators were prioritized according to value using the contingency functions developed by the SMEs. Conclusion Our article provides an actionable guide to applying ProMES, which can be adapted to the needs of various industries, including measure selection and modification from existing data sources, and proposing new measures. Future work should address both logistical considerations (e.g., data capture, common data/programming language) and lingering measurement challenges, such as operationalizating measures to be meaningful and interpretable across health care settings.
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    Churning the tides of care: when nurse turnover makes waves in patient access to primary care
    (Springer Nature, 2024) Arredondo, Kelley; Hughes, Ashley M.; Lester, Houston F.; Pham, Trang N.D.; Petersen, Laura A.; Woodard, LeChauncy; SoRelle, Richard; Jiang, Cheng (Rebecca); Oswald, Frederick L.; Murphy, Daniel R.; Touchett, Hilary N.; Hamer, Joshua; Hysong, Sylvia J.
    Team-based primary care (PC) enhances the quality of and access to health care. The Veterans Health Administration (VHA) implements team-based care through Patient Aligned Care Teams (PACTs), consisting of four core members: a primary care provider, registered nurse (RN) care manager, licensed vocational nurse, and scheduling clerk. RNs play a central role: they coordinate patient care, manage operational needs, and serve as a patient point of contact. Currently, it is not known how varying levels of RN staffing on primary care teams impact patient outcomes.