topic : Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. Explain how this model is advantageous to patient outcomes.
Example 1 ( amira) One innovative health care delivery model that has gained traction is the Patient-Centered Medical Home (PCMH) approach, which emphasizes comprehensive and coordinated care delivered by an interdisciplinary team. In the PCMH model, patients have a designated primary care provider who leads a team of professionals, including nurses, pharmacists, social workers, and other specialists (Perez Jolles et al., 2019). This team works collaboratively to address the diverse needs of patients, ranging from preventive care to chronic disease management.
One significant advantage of the PCMH model is its focus on holistic patient care. By integrating various healthcare professionals into the care team, patients receive comprehensive services that address not only their medical needs but also their social, emotional, and behavioral health needs. For example, a patient with diabetes may not only receive medical management from their physician but also benefit from dietary counseling from a nutritionist and support in managing stress and mental health from a psychologist or social worker (Stockdale et al., 2021). This holistic approach has been shown to improve patient outcomes by addressing the root causes of health issues and promoting overall well-being.
The PCMH model promotes care coordination and communication among team members, leading to improved efficiency and effectiveness in delivering healthcare services. With a designated primary care provider overseeing the patient’s care, there is better continuity and consistency in treatment plans, medication management, and follow-up care. This coordination reduces the likelihood of medical errors, redundant tests, and unnecessary hospitalizations, ultimately resulting in better health outcomes for patients (Perez Jolles et al., 2019). Furthermore, the emphasis on preventive care and early intervention in the PCMH model helps to reduce healthcare costs in the long run by minimizing the need for costly emergency interventions and hospitalizations. Overall, the PCMH model represents a promising approach to healthcare delivery that prioritizes patient-centered, comprehensive, and coordinated care, ultimately leading to improved health outcomes for individuals and communities.
References
Perez Jolles, M., Lengnick-Hall, R., & Mittman, B. S. (2019). Core functions and forms of complex health interventions: A patient-centered medical home illustration. Journal of General Internal Medicine, 34(6), 1032-1038. https://doi.org/10.1007/s11606-018-4818-7
Stockdale, S. E., Katz, M. L., Bergman, A. A., Zulman, D. M., Denietolis, A., & Chang, E. T. (2021). What do patient-centered medical home (PCMH) teams need to improve care for primary care patients with complex needs? Journal of General Internal Medicine, 36(9), 2717-2723. https://doi.org/10.1007/s11606-020-06563-x
Example 2 ( Jenna) The Patient-Centered Medical Home (PCMH) model is an innovative health care delivery model that incorporates an interdisciplinary care delivery team. This model is a comprehensive, patient-centered approach to primary care that involves a group of health care professionals to work together as a team to provide high quality care to patients. This model takes an approach to deliver quality and cost-effective primary care to patients. Patients are engaged in a direct relationship with a chosen provider who then coordinates the health care team. Then the interdisciplinary care team works together to collectively be responsible for the comprehensive integrated care provided to the patient. The patient is advocated for, and proper arrangements are made to make sure the patient is getting the high-quality care they deserve with qualified providers and community resources. The PCMH model has been associated with effective chronic disease management, increased patient and provider satisfaction, cost savings, improved quality of care and increased preventive care. Using a patient centered, culturally appropriate, and team-based approach, the PCMH model coordinates patient care across the health system successfully. CDC. (2021, May 12). Patient-Centered Medical Home (PCMH) Model . Centers for Disease Control and Prevention. https://www.cdc.gov/dhdsp/policy_resources/pcmh.htm Patient-Centered Medical Home. (n.d.). Association of Clinicians for the Underserved. https://clinicians.org/programs/programs-resource-archive/patient-centered-medical-home/
Example 3 (Adriana)
The Program of All-Inclusive Care for the Elderly (PACE) model incorporates a collaborative approach to healthcare by improving patient outcomes, organizing case management, and utilizing resources (Arku et al., 2022). This model uses a team-based focus by bringing primary care providers, specialists, and case management to help curate holistic patient care. Organized, comprehensive care can lead to optimal patient outcomes to help address physical and mental health issues. Within this model, a RN case manager is implemented to assist in performing a variety of tasks, such as patient education in ensuring adhering to interventions, scheduling follow ups, and providing referrals when needed (Reist et al., 2022). Maintaining continuity of care ensures optimal patient outcomes are achievable within this delivery model. Like other healthcare delivery models such as the Collaborative Care, patient care evolves to meet the current needs of the patient by maintaining constant communication with the patient. Patients are provided wellness calls and reassessments twice a year with their multidisciplinary team to identify any changes and prevent worsening of any current morbidities. The multidisciplinary team can create rapport with these patients allowing a trustworthy bond to ensure their care needs are met. Reference:
Arku, D., Felix, M., Warholak, T., & Axon, D. R. (2022). Program of All-Inclusive Care for the Elderly (PACE) versus Other Programs: A Scoping Review of Health Outcomes. Geriatrics (Basel, Switzerland), 7(2), 31.
Reist, C., Petiwala, I., Latimer, J., Raffaelli, S. B., Chiang, M., Eisenberg, D., & Campbell, S. (2022). Collaborative mental health care: A narrative review. Medicine, 101(52), e32554.
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